Imaging funzionale per diffusione (DWI) e ischemia cerebrale in fase acuta: Potenzialità diagnostiche e confronto con metodiche convenzionali

Stroke is the third leading cause of death and is a major cause of long-term disability. Neuroprotective treatment within a 4-hour «therapeutic window» has proved highly efficacious in reducing morbility and mortality in animal model. It is with this background that the need for emergent diagnosis and therapy of acute stroke in strongly suggested. Computed tomography (CT) shows the parenchymal changes of acute stroke too late to be helpful, and its role has been primarily to evaluate the possibility of intracerebral or subarachnoid hemorrhage. While conventional magnetic resonance (MR) imaging can demonstrate parenchymal abnormalities 4–6 hours after ischemia, newer techniques such as diff…

Incidentally discovered thyroid nodules: incidence, and greyscale and colour Doppler pattern in an adult population screened by real-time compound spatial sonography

Purpose. Our aim was to assess the incidence and ultrasound features of thyroid nodules in an adult population screened by means of high-resolution ultrasonography (HRUS) and to evaluate the contribution of real-time spatial compound sonography (CS) in terms of image quality. Materials and methods. A total of 704 consecutive patients (400 women, 304 men) without thyroid disease underwent HRUS and CS examination of the thyroid gland. Number, size, location, echotexture and colour Doppler pattern of detected nodules were assessed. Two radiologists also assessed image quality of the two techniques. Results. Seven hundred and eleven thyroid nodules (size range 0.18-4.1 cm; mean: 1.1 cm) were de…

Retroaortic left renal vein joining the left common iliac vein

Retroaortic left renal vein joining the left common iliac vein is a rare congenital anomaly in the development of the inferior vena cava. To our knowledge, only one case has been reported in the literature; however, its imaging features have never been described. A 27-year-old male presented with a 1-year history of recurrent right flank pain, dysuria, hematuria, and fever (39 degrees C). Computed tomography and MR venography showed a retroaortic left renal vein joining the left common iliac vein. We present the CT and MR venography findings and discuss their feasibility in showing this congenital anomaly.

Usefulness of Contrast-enhanced Ultrasonography in the Monitoring and follow-up of Treatment Response in Patients with Crohn’s Disease

Benign focal liver lesions: spectrum of findings on SonoVue-enhanced pulse-inversion ultrasonography.

The prevalence of benign focal liver lesions (BFLL) is high both in the general population and in patients with known malignancies. The gray-scale ultrasound (US) technique is usually the first-line imaging modality used in the radiological workup of such lesions, but unfortunately it lacks specificity. Furthermore, Doppler examination may often be unsatisfactory owing to motion artefacts, or when small or deeply located lesions are evaluated. Recently, microbubble-based contrast agents used in combination with gray-scale US techniques, which are very sensitive to nonlinear behavior of microbubbles, have led to a better depiction of both microvasculature and macrovasculature of focal hepati…

Case 80: splenosis.

Valutazione della risposta al trattamento con termoablazione percutanea con radiofrequenza dell’epatocarcinoma: ruolo dell’ecografia con mezzo di contrasto

Palliative splenic irradiation in primary and post PV/ET myelofibrosis: outcomes and toxicity of three radiation schedules

Splenectomy and splenic irradiation (SI) are the sole treatment modalities to control drug resistant splenomegaly in patients with myelofibrosis (MF). SI has been used in poor surgical candidates but optimal total dose and fractionation are unclear. We retrospectively reviewed 14 MF patients with symptomatic splenomegaly. Patients received a median of 10 fractions in two weeks. Fraction size ranged from 0.2–1.4 Gy, and total dose varied from 2–10.8 Gy per RT course. Overall results indicate that 81.8% of radiation courses achieved a significant spleen reduction. Splenic pain relief and gastrointestinal symptoms reduction were obtained in 94% and 91% of courses, respectively. Severe cytopeni…

Renal endometriosis mimicking complicated cysts of kidney: report of two cases

Endometriosis is a common gynecologic disorder characterized by ectopic endometrial tissue growth outside the uterine cavity. Although usually occurring in pelvic organs, endometrial lesions may involve urinary tract. Renal endometriosis is extremely rare and it has only occasionally been reported in the past. We report two cases of patients with renal cystic lesions, incidentally found at imaging techniques during oncologic follow-up for gastric sarcoma and melanoma, initially misinterpreted as complicated haemorrhagic cysts and then histologically characterized as renal localizations of extragenital endometriosis.

Imaging dell'amiloidosi cardiaca in Risonanza Magnetica: Case Report.

Amyloidosis is a rare group of diseases characterized by the deposition of amyloid protein level of various tissues and organs, including myocardial tissue, with progressive evolution towards heart failure. We report the case of a 76-year-old male patient with dyspnoea and easy fatigue, whose picture of Magnetic resonance imaging enabled the diagnosis of cardiac amyloidosis.

Effects of the static magnetic field generated by 0.5 T MRI unit on TNF-α release of human PBMC from patients with rheumatoid arthritis.

CONFRONTO TRA RM WHOLE BODY E PET/TC NELLA STADIAZIONE DEI LINFOMI FDG-AVIDI.

Scopo Scopo del nostro studio è stato quello di comparare la RM whole body (RM-WB) con la PET/TC nella stadiazione dei linfomi FDG-avidi. Materiale e metodi 68 pazienti (37 maschi, età mediana 42 anni, range 15-86) con diagnosi istologica di Linfoma (37 Hodgkin, 16 Diffuso B a grandi cellule, 10 Follicolare, 5 Mantellare) sono stati sottoposti a RM-WB e PET/TC prima del trattamento. Sono stati valutati e confrontati sensibilità, specificità, valore predittivo positivo e negativo (PPV e NPV) della RM-WB e PET/TC, quest’ultima considerata come standard di riferimento. Lo stadio Ann Arbor (AA) ottenuto con RM-WB (sequenze DWIBS assiali, T1w e T2w-STIR coronali, senza mezzo di contrasto) e con …

Valore dell'esame TC di perfusione nell'ischemia cerebrale acuta

DIGITAL CINERADIOGRAPHIC STUDY OF SWALLOWING IN PATIENTS WITH AMYOTROPHIC LATERAL SCLEROSIS

Purpose. This study was performed to evaluate the usefulness of digital cineradiography in detecting swallowing disorders in dysphagic patients affected by amyotrophic lateral sclerosis (ALS) with a view to planning an adequate therapeutic approach. Material and methods. From January 2005 to September 2006, 23 patients (10 men and 13 women; mean age 41.3±8.6 years) affected by ALS were evaluated with digital cineradiography to assess the grade of dysphagia. All patients were classified using the Hillel ALS Severity Scale (ALSSS). All examinations were performed with radiocontrolled equipment provided with a digital C-arm. Results. The cineradiographic technique enabled us to differentiate p…

Imaging findings of liver resection using a bipolar radiofrequency electrosurgical device—Initial observations

Abstract Objective To assess contrast-enhanced US (CEUS), computed tomography (CT) and magnetic resonance (MR) imaging findings and serial changes of the treated area at follow-up in patients who underwent liver resection using a bipolar radiofrequency electrosurgical device. Methods Imaging findings of 27 patients with resected hepatocellular carcinomas (HCCs) ( n  = 24) and metastases ( n  = 3) (mean size: 2.6 cm), were retrospectively evaluated. Two readers assessed: the (a) presence, (b) thickness, (c) shape and (d) echogenicity (CEUS)/attenuation (CT)/signal intensity (MR imaging) at coagulated site and the (e) presence of residual tumor of the bipolar radiofrequency electrosurgical de…

Liver haemangiomas undetermined at grey-scale ultrasound: contrast-enhancement patterns with SonoVue and pulse-inversion US.

The objective of this study was to describe the spectrum of contrast-enhancement patterns of hepatic haemangiomas undetermined at grey-scale ultrasound (US) on SonoVue-enhanced pulse-inversion (PI) US. Twenty patients (11 women, nine men) with 35 haemangiomas (size range: 1-7 cm; mean: 3.1 cm) undetermined at baseline US underwent PI at low M.I. (0.05-0.08) after i.v. injection of SonoVue. All haemangiomas were confirmed by typical helical computed tomography (CT) and/or magnetic resonance imaging (MRI) findings. US examinations were videotaped and then reviewed by two experienced radiologists blinded to the final diagnosis. Readers evaluated by consensus the baseline echogenicity and the d…

Tumor enhancement at contrast-enhanced CT and Gd-enhanced MRI for the assessment of treatment response of hepatocellular carcinoma (HCC) after sorafenib

Scopo: To investigate whether arterial enhancement of advanced HCC during pre-treatment and follow-up contrast-enhanced CT (CECT) or Gd-enhanced MRI (Gd-MRI) can be used to predict tumor response to sorafenib. Materiali e metodi: Seventeen patients (12M, 5F; mean age: 69 years) receiving sorafenib for inoperable HCC between 2007 and 2010 were included. Median interval time between pre-treatment and follow-up CECT or Gd-MRI was 160 days. Tumor arterial enhancement was measured at baseline and follow-up: (tumor attenuation/intensity on arterial phase – tumor attenuation/intensity on unenh! anced images)/(tumor attenuation/intensity on unenhanced images) x 100. Response was assessed according …

Congenitally corrected transposition of great vessels: MRI and echocardiographic appearance

This paper presents the case of a 36-year-old male with congenitally corrected transposition of great vessels (CTGV). This is a rare cardiac anomaly characterized by atrioventricular and ventriculoarterial discordance, occuriing in less than 1% of all congenital heart diseases. This was diagnosed by echocardiography and MRI. The MRI findings demonstrated cardiac abnormality.

Perfusion MRI in normal and abnormal pituitary gland. A preliminary study.

Perfusion MRI (magnetic resonance imaging) of the pituitary gland was performed in 20 healthy volunteers and 63 patients with various lesions involving the pituitary gland. All patients underwent sequential contrast-enhanced MRI using spoiled gradient recalled sequences with high temporal resolution (7 seconds). Four pituitary areas (pituitary stalk, posterior lobe, postero-superior, and antero-inferior adenohypophysis) were tested with a selected region of interest. Maximal contrast percentual variation was calculated. The timing of enhancement in normal patients matched perfectly with normal pituitary vascularization. Abnormal timing in pathological condition was investigated.

Conventional Radiology in the Evaluation of the Small Bowel

For many years, the small bowel has been considered as the “black box” of the gastrointestinal system because it could not be evaluated through endoscopy. For this reason, the conventional radiological methods, such as small bowel enteroclysis and small bowel follow-through, have been considered the standard approach for the evaluation of the small bowel in the diagnosis and management of Crohn’s disease for years. However, due to technological limits, the study of small bowel through conventional radiology has been focused mainly on its function than on its anatomy. To date, the conventional examination with the study of intestinal transit is now rarely used, if not obsolete, but it has st…

Può la misura della densità tumorale essere considerata un parametro attendibile nella valutazione della risposta ai trattamenti antiangiogenetici ed un fattore predittivo della PFS nell'HCC avanzato?

Virtopsy and Living Individuals Evaluation Using Computed Tomography in Forensic Diagnostic Imaging

The applications of forensic radiology involve both Virtopsy both studies on living people - to demonstrate bone age, search for foreign bodies, such as voluntary injection of drug ovules or surgical sponges accidentally forgotten, to assess gunshot wounds, to evaluate injuries by road accidents, and cases of violence or abuse (both in adults and in children). Computed tomography is the most used imaging tool used in forensic pathology and its indications are mainly focused on cases of unnatural deaths or when a crime is suspected. It is preferred over the standard autopsy in selected cases, such as in putrefied, carbonized or badly damaged bodies; or as a preliminary evaluation in mass dis…

TC perfusionale nell'ischemia cerebrale acuta: Valore predittivo dei parametri di perfusione cerebrale nel discriminare il tessuto vitale da quello infartuato

Purpose. The aim of this study was to assess the value of computed tomography (CT) perfusion parameters in differentiating tissue viability in acute stoke patients. Materials and methods. Thirteen patients (mean age 63.3 years) with nonhaemorrhagic stroke underwent multidetector perfusion CT within 3 h of symptom onset. Images were continuously acquired at the basal ganglia over 40 s during injection of 90 ml of iodinated contrast medium injected at a rate of 9 ml/s with a 9-s delay. Z-axis coverage was 20 mm. All patients underwent diffusion-weighted magnetic resonance imaging (DWI) within 12 h of perfusion CT to define the extent of the infarct. Perfusion CT data were analysed in regions …

Hepatocellular carcinoma in cirrhotic patients at multidetector CT: hepatic venous phase versus delayed phase for the detection of tumour washout.

OBJECTIVES: Our aim was to compare retrospectively hepatic venous and delayed phase images for the detection of tumour washout during multiphasic multidetector row CT (MDCT) of the liver in patients with hepatocellular carcinoma (HCC). METHODS: 30 cirrhotic patients underwent multiphasic MDCT in the 90 days before liver transplantation. MDCT was performed before contrast medium administration and during hepatic arterial hepatic venous and delayed phases, images were obtained at 12, 55 and 120 s after trigger threshold. Two radiologists qualitatively evaluated images for lesion attenuation. Tumour washout was evaluated subjectively and objectively. Tumour-to-liver contrast (TLC) was measured…

Valutazione semi-automatica dell’impregnazione post-contrastografica delle anse intestinali sede di malattia di Crohn, utilizzando diverse finestre temporali.

Patologia congenita

MR-imaging features of hepatocellular carcinoma capsule appearance in cirrhotic liver: comparison of gadoxetic acid and gadobenate dimeglumine.

Purpose: The purpose of the study is to compare the MR-imaging features of hepatocellular carcinoma (HCC) capsule appearance on gadoxetic acid and gadobenate dimeglumine-enhanced MR imaging, using imaging-based presumptive diagnosis of HCC as the reference standard. Methods: Gadoxetic acid and gadobenate dimeglumine-enhanced MR imaging of 51 patients with 71 HCCs were retrospectively reviewed. Three readers graded in consensus, using a five-point scale, the presence (score 4–5) of capsule appearance on images obtained during T1-weighted GRE portal venous phase (PVP), 3-min phase, and hepatobiliary phase (HBP). The Fisher's exact test and the t student unpaired test were performed. Results: …

Coartazione aortica in tomografia computerizzata multistrato

Aortic coarctation (CA) is a congenital focal narrowing of the aortic lumen forming part of an arteriopathy generalized (5-8% of all congenital heart diseases). Classically distinct in a predeterminal and postductal form, at present this classification is not used much. Clinical manifestations of affected patients range from systolic hypertension of the originating vessels a upstream of the part coarctated to the hypotension dependent on those downstream and strictly depend on the degree of stenosis.

Whole-body diffusion-weighted MR and FDG-PET/CT in Hodgkin Lymphoma: Predictive role before treatment and early assessment after two courses of ABVD

Abstract Purpose To evaluate whether imaging features of pathologic lymph nodes on whole-body diffusion-weighted MR have a predictive role before treatment and may assess the response after two courses of chemotherapy in comparison to FDG-PET/CT in Hodgkin Lymphoma. Materials and methods We reviewed the whole-body MR and FDG-PET/CT performed on 41 patients with Hodgkin Lymphoma before and after two Doxorubicin-Bleomycin-Vinblastine-Dacarbazine (ABVD). Responder and non-responder lesions were identified on interim-FDG-PET/CT performed after two ABVD. We used Multivariate Generalized Estimating Equations model to assess statistical association between being-responder and baseline-Maximum Stan…

ASPETTI TC ED RM NELLA RETRAZIONE CAPSULARE EPATICA

ASPETTI TC ED RM NELLA RETRAZIONE CAPSULARE EPATICA

Reward networks changes in the brain of pathological gamblers: a resting state functional magnetic resonance imaging study

Aims and objectives Methods and materials Results Conclusion Personal information References

RUOLO DELL'ECOGRAFIA CON MEZZO DI CONTRASTO NELLA MALATTIA DI CROHN

RUOLO DELL'ECOGRAFIA CON MEZZO DI CONTRASTO NELLA MALATTIA DI CROHN Nome del convegno: 41° Congresso Nazionale SIRM Luogo del convegno: Palermo Anno del convegno: MAGGIO 2004 Dettaglio tipologia d'Ateneo: 10 - Abstract di Comunicazioni o Poster di Congressi nazionali pubblicati (anche on line)

Benign and malignant conditions in hepatic capsular retraction

Cardioradiologia

Whole-body MRI, FDG-PET/CT, and bone marrow biopsy, for the assessment of bone marrow involvement in patients with newly diagnosed lymphoma.

To compare whole-body MRI (WB-MRI) with diffusion-weighted imaging (DWI), FDG-PET/CT, and bone marrow biopsy (BMB), for the evaluation of bone marrow involvement (BMI) in patients with newly diagnosed lymphoma.This retrospective study was approved by our Institutional Review Board. Two independent radiologists and one nuclear medicine specialist reviewed all WB-MRI and FDG-PET/CT scans prospectively performed on 104 patients with newly diagnosed lymphoma (53 males; 47 Hodgkin; mean age: 44 years; range, 15-86 years) between 2013 and 2015. The delay between imaging scans and BMBs was up to 10 days. The diagnostic accuracy of WB-MRI (1.5 Tesla MR scanner, with T1w, T2w-STIR, and DWI sequences…

Biological effects of ultrasound

Osteonecrosis detected by whole body magnetic resonance (WB-MRI) in patients with Hodgkin lymphoma treated by BEACOPP

Purpose: The purpose of our retrospective study was to assess the incidence of osteonecrosis in patients who received different chemotherapies. Methods and Materials: We evaluated the Whole Body Magnetic Resonance (WB-MRI) scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6 ABVD, 2 ABVD + 4 BEACOPP, 2 ABVD + 8 BEACOPP), excluding the patients with main risk factors for osteonecrosis. Results: Six out of 7 patients (85.7%) who received 8 BEACOPP and 1 out of 5 patients (20%) treated by 4 BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients (p<0.05); no injury has been reporte…

Cavernous haemangioma associated with other hepatic masses at CT and MRI

Cavernous haemangioma associated with other hepatic masses at CT and MRI Nome del convegno: ESGAR 2004 Dettaglio tipologia d'Ateneo: 9 - Abstract di Comunicazioni o Poster di Congressi internazionali pubblicati (anche on line)

Il Tecnezio: storia, usi e applicazioni.

To bring to the knowledge of all the Italian paternity of the discovery of the first artificial chemical element in history: the Technetium or Technetium (Tc).

Aorta addominale e vasi splancnici

PI-RADS 3 Lesions: Role of Prostate MRI Texture Analysis in the Identification of Prostate Cancer

Abstract Purpose To determine the diagnostic performance of texture analysis of prostate MRI for the diagnosis of prostate cancer among Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions. Materials and Methods Forty-three patients with at least 1 PI-RADS 3 lesion on prostate MRI performed between June 2016 and January 2019 were retrospectively included. Reference standard was pathological analysis of radical prostatectomy specimens or MRI-targeted biopsies. Texture analysis extraction of target lesions was performed on axial T2-weighted images and apparent diffusion coefficient (ADC) maps using a radiomic software. Lesions were categorized as prostate cancer (Gleason score [GS] …

Contrast-Enhanced Ultrasound in Focal Liver Lesions: Where Do We Stand?

Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in sonography, and it is being increasingly used for the evaluation of focal liver lesions (FLLs). Currently, CEUS is included as a part of the suggested diagnostic workup of FLLs, resulting in a better patient management and delivering cost-effective therapy. After a brief technical note, contrast-enhancement patterns of different types of benign and malignant FLLs, along with hepatic pseudolesions, are described and discussed based on our experience and literature data. At the same time, the most recent concepts and the use of CEUS in different clinical settings are presented.

Detection of liver metastases in cancer patients with geographic fatty infiltration of the liver: the added value of contrast-enhanced sonography

Purpose The aim of this study is to assess the role of contrast-enhanced ultrasonography (CEUS) in the detection of liver metastases in cancer patients with geographic liver fatty deposition on greyscale ultrasonography (US). Methods Thirty-seven consecutive cancer patients (24 women and 13 men; age, 33 to 80 years; mean, 58.1 years) with geographic liver fatty deposition, but without any detectable focal liver lesion on greyscale US, underwent sulphur hexafluoride-enhanced US. Two readers reported by consensus the presence, size, and location of any detected lesion. All patients underwent magnetic resonance imaging (MRI) as a confirmatory study. Sensitivity, specificity, positive and negat…

Hepatic focal nodular hyperplasia: contrast-enhanced ultrasound findings with emphasis on lesion size, depth and liver echogenicity

To correlate contrast-enhanced ultrasound (CEUS) findings of hepatic focal nodular hyperplasia (FNH) with lesion size, depth and liver echogenicity and to compare CEUS with baseline US. Two radiologists evaluated baseline US and CEUS examinations of 92 FNHs (mean size: 3.1 +/- 1.7 cm) in 71 patients (59 women and 12 men) to detect the "spoke-wheel" sign, central scar and feeding vessel. The FNHs were grouped and analysed by dimension, depth and liver echogenicity. At least one sign could be detected at CEUS in 27 out of 36 (75%) FNHs larger than 3 cm and in 17 out of 56 (30%) FNH measuring 3 cm or less (p 0.05) as well as between CEUS or baseline US/CD with regard to lesion size, depth or l…

Imaging features of solid renal masses

The widespread use of abdominal imaging techniques has increased the detection of solid renal masses over the past years. Imaging plays a crucial role in the management and surveillance and in determining which lesions need treatment. The "classical angiomyolipoma" is the only benign solid renal mass that can be characterized with confidence by imaging through the detection of a fat-containing lesion without calcifications. There is a large overlap of imaging features between benign and malignant renal masses that often makes difficult a correct characterization of these lesions. In this review, we discuss the imaging features of the main solid renal masses that may suggest a likely benign …

Imaging findings of cerebral involvement in end-stage renal failure patients on hemodialysis

Analisi retrospettiva degli errori di posizione dei pazienti e l'impatto della dose nella colonscopia virtuale mediante TCMS: esperienza di un singolo centro

La Colonscopia virtuale (CV) tramite tomografia computerizzato multi-strato (TCMS) è una nota e valida tecnica alternativa alla colonscopia ottica per la valutazione della parete del colon e la individuazione di nuove lesioni. Lo svantaggio principale per la sua esecuzione è l’esposizione del paziente alle radiazioni ionizzanti. Questo è il motivo per cui linee guida raccomandano procedure di acquisizione a basso dosaggio standardizzate volte a ridurre al minimo le radiazioni di esposizione. Abbiamo retrospettivamente esaminato l'impatto in termini di esposizione alle radiazioni ionizzanti in base alla posizione del paziente e la durata della scansione. [1].

Contrast.enhanced ultrasonography of liver hemangiomas atypical at baseline US.

Tomografia computerizzata e risonanza magnetica

Imaging of Gastrointestinal Stromal Tumors: From Diagnosis to Evaluation of Therapeutic Response

Once considered an obscure tumor entity with poor prognosis, gastrointestinal stromal tumors (GISTs) are nowadays recognized as the most common mesenchymal tumors of the alimentary tract. GISTs differ from other mesenchymal neoplasms at pathology since 90% of them exhibit strong immunohistochemical staining for KIT, a tyrosinase kinase growth factor receptor. In the early 2000s, the ability of imatinib mesylate, a tyrosine kinase inhibitor, to inhibit KIT established a new paradigm for cancer treatment. A reduction in lesion size may not be observed or may appear many months after therapy; thus, tumor response criteria alternative to the Response Evaluation Criteria in Solid Tumors were dev…

Radiological Features of Gastrointestinal Lymphoma.

Gastrointestinal lymphomas represent 5–20% of extranodal lymphomas and mainly occur in the stomach and small intestine. Clinical findings are not specific, thus often determining a delay in the diagnosis. Imaging features at conventional and cross-sectional imaging must be known by the radiologist since he/she plays a pivotal role in the diagnosis and disease assessment, thus assisting in the choice of the optimal treatment to patients. This review focuses on the wide variety of imaging presentation of esophageal, gastric, and small and large bowel lymphoma presenting their main imaging appearances at conventional and cross-sectional imaging, mainly focusing on computed tomography and magne…

Diagnosi di osteonecrosi mediante WB-MRI in paziente con Linfoma di Hodgkin resistente trattato con BEACOPP: Case Report.

Hodgkin's lymphoma is a very common haematological neoplasm with high possibilities of response to treatment. On the other hand, therapies are often responsible for clinically relevant complications. Among these is osteonecrosis, generally determined by the high dosages of corticosteroids included in the chemotherapeutic protocols, which lead to bone ischemia through multifactorial mechanisms such as hypercoagulability and increase of intraosseous pressure due to hyperplasia of the adipose component. We report the case of a 29-year-old man with resistant Hodgkin's lymphoma undergoing chemotherapy which determined the appearance of multifocal osteonecrosis detected by Magnetic Resonance whol…

Relazione tra decorsi miocardici e carico aterosclerotico coronarico studiata mediante angiografia coronarica con TC a 64 strati (AC-TCMS)

Digital cineradiographic study of swallowing in infants with neurologic disease. Our experience

Esame radiologico del torace nell’invecchiamento cardiaco

L’invecchiamento e un processo fisiologico, definito omeostenosi caratterizzato da un progressivo declino dell’omeostasi di diversi organi e apparati in assenza di segni e/o sintomi di malattia. Le modificazioni anatomo-patologiche a carico dell’apparato cardiocircolatorio iniziano a comparire gia dalla terza decade di vita con incremento del grasso pericardico, progressivo irrigidimento delle valvole cardiache con segni di insufficienza e/o stenosi. Nella parete cardiaca si puo documentare ipertrofia del miocardio con incremento volumetrico delle fibrocellule muscolari lisce, prevalentemente a carico del distretto sinistro. Analoghe modificazioni sono riscontrabili nella parete vasale del …

Heterogeneous delayed enhancement of hepatic parenchyma after intravenous infusion of sonographic contrast agent: a new hypothesis

Purpose. The aim of this paper was to report a heterogeneous latephase hepatic enhancement pattern observed after administration of a sonographic contrast agent and to present an aetiological hypothesis for the phenomenon. Materials and methods. A total of 1,729 (1,012 women and 717 men; age range 28–82; mean age 51) patients underwent contrastenhanced sonography of the liver. The examination was performed with a low mechanical index (MI <0.09) after injection of sulphur-hexafluoride-filled microbubbles, using different fonographic equipment and different contrast-specific algorithms. Results. Heterogeneous delayed liver enhancement was observed in six patients in the late phase (180 s), wi…

Health technology assessment della TC del cuore: analisi globale e multidisciplinare della procedura diagnostica

A CASE OF A PRESACRAL MYELOLIPOMA: IMAGING FINDINGS AND DIFFERENTIAL DIAGNOSIS CHECKLIST OF OTHER PRESACRAL MASSES

PURPOSE: There have been many reports describing adrenal myelolipoma but there have been only few reports of extraadrenal myelolipoma. We describe a case of an elderly woman with lower back pain due to age-related spondyloarthrosis and mild discopathy with a presacral myelolipoma as incidental finding. We also discuss about common and uncommon imaging findings of other presacral masses. METHODS: A 74 years-old woman came to our observation to perform an MRI of the lumbar spine for typical lumbar back pain. MR imaging revealed, in addition to the signs of mild scoliosis and spondylo-disc-arthrosis, a presacral mass showing heterogeneously high signal in all sequences and almost completely su…

Computer-Assisted Approaches for Uterine Fibroid Segmentation in MRgFUS Treatments: Quantitative Evaluation and Clinical Feasibility Analysis

Nowadays, uterine fibroids can be treated using Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS), which is a non-invasive therapy exploiting thermal ablation. In order to measure the Non-Perfused Volume (NPV) for treatment response assessment, the ablated fibroid areas (i.e., Region of Treatment, ROT) are manually contoured by a radiologist. The current operator-dependent methodology could affect the subsequent follow-up phases, due to the lack of result repeatability. In addition, this fully manual procedure is time-consuming, considerably increasing execution times. These critical issues can be addressed only by means of accurate and efficient automated Pattern Recognition ap…

Radiomics: A New Biomedical Workflow to Create a Predictive Model

‘Radiomics’ is utilized to improve the prediction of patient overall survival and/or outcome. Target segmentation, feature extraction, feature selection, and classification model are the fundamental blocks of a radiomics workflow. Nevertheless, these blocks can be affected by several issues, i.e. high inter- and intra-observer variability. To overcome these issues obtaining reproducible results, we propose a novel radiomics workflow to identify a relevant prognostic model concerning a real clinical problem. In the specific, we propose an operator-independent segmentation system with the consequent automatic extraction of radiomics features, and a novel feature selection approach to create a…

Approaches and techniques for imaging guided for needle placement in MR Arthrography of the shoulder

contrast enhanced versus conventional ultrasonography in the characterization of benign focal hepatic lesions

Hepatocellular carcinoma (HCC) with indeterminate findings at initial CT or MRI: Does imaging follow-up allow detection of conclusive imaging findings before significant tumor growth?

Ultrasound contrast agent in the study of traumatic splenic rupture

Hamartoma of the urinary bladder: case report and review of the literature.

Bladder hamartoma is a rare benign entity with only eight cases reported in the literature thus far, and whose general imaging features have not, to our knowledge, been previously discussed. The purpose of this report is to review the literature and to discuss the imaging findings in one case of bladder hamartoma where US features were those of an inhomogeneous solid mass with an unechogenic center, which was in accordance with the CT findings of a soft tissue mass with central inhomogeneous enhancement due to central necrosis.

Magnetic resonance findings in scuba diving-related spinal cord decompression sickness

Scuba diving is associated with risk of severe decompression sickness (DCS type II), which results from rapid reduction of the environmental pressure sufficient to cause the formation into tissue or blood of inert gas bubbles previously loaded within tissues as a soluble phase. DCS type II constitutes a unique subset of ischemic insults to the central nervous system (CNS) with primarily involvement of the spinal cord. Ten patients with diving-related barotrauma underwent neurologic examination. Two of them presented progressive sensory and motor loss in the extremities at admission and were presumed affected by spinal cord DCS. Magnetic resonance imaging (MRI) demonstrated abnormalities in …

BIOLOGICAL EFFECTS FROM ULTRASOUNDS WITH PULSE INVERSION AND CONTRAST MEDIUM ON THE RABBIT KIDNEY

THE ROLE OF ULTRASONOGRAPHY IN THE DIAGNOSIS, AS GUIDING TOO FOR TREATMENT AND IN FOLLOW-UP OF IDIOPATIC PLANTAR FASCITIS

Whole-body MRI, FDG-PET/CT, and bone marrow biopsy, for the assessment of bone marrow involvement in patients with newly diagnosed lymphoma

Purpose To compare whole-body MRI (WB-MRI) with diffusion-weighted imaging (DWI), FDG-PET/CT, and bone marrow biopsy (BMB), for the evaluation of bone marrow involvement (BMI) in patients with newly diagnosed lymphoma. Materials and Methods This retrospective study was approved by our Institutional Review Board. Two independent radiologists and one nuclear medicine specialist reviewed all WB-MRI and FDG-PET/CT scans prospectively performed on 104 patients with newly diagnosed lymphoma (53 males; 47 Hodgkin; mean age: 44 years; range, 15–86 years) between 2013 and 2015. The delay between imaging scans and BMBs was up to 10 days. The diagnostic accuracy of WB-MRI (1.5 Tesla MR scanner, with T…

Bladder tumor staging: comparison of contrast-enhanced and gray-scale ultrasound

OBJECTIVE. The purpose of this study was to evaluate the effectiveness of contrast-enhanced sonography in comparison with conventional sonography in differentiating muscle- infiltrating and superficial neoplasms of the urinary bladder. SUBJECTS AND METHODS. Conventional and contrast-enhanced sonography were performed on 34 consecutively registered patients with bladder tumors. All examinations were reviewed by two independent sonologists. At gray-scale sonography, interruption of the hyperechoic bladder wall was considered the main diagnostic criterion for differentiating superficial and infiltrating tumors. At contrast-enhanced sonography, a tumor was considered superficial when the hypoen…

Whole-body MRI in patients with lymphoma: collateral findings.

To assess the incidence of collateral findings detected on whole-body magnetic resonance (WB-MRI) scans performed on patients with lymphoma. 114 patients (65 male; median age 45.2 years, range 15–86) with histologically confirmed lymphoma (47 Hodgkin, 67 Non-Hodgkin) underwent WB-MRI. The collateral findings were classified into three classes, according to their clinical significance, as follows: not or low significant (class 1), moderately or potentially significant (class 2), and significant (class 3). A Chi-square (χ 2) test was performed to assess the statistical significance of differences in the incidence of collateral findings based on age (≤50 and >50 years old), gender and histolog…

Centrifugal (inside-out) enhancement pattern of liver hemangiomas on contrast-enhanced US

Gastrointestinal stromal tumor (GIST): 40-row multislice computed tomography findings

Relationship between anxiety level and radiological investigation. Comparison among different diagnostic imaging exams in a prospective single-center study

Objective: Every patient could feel anxious when he waits in a radiological department to undergo diagnostic exams. The aim of our study is to evaluate the impact of the radiological exams on patient anxiety. Materials and methods: We evaluated 343 patients (mean age 54.83 years) who underwent different types of diagnostic exams in the Department of Diagnostic Imaging at our Hospital from April 2013 to August 2014. We administered to patients the State and Trait Anxiety Inventory Test, which detected with high sensitivity both state anxiety and trait anxiety. A team of clinical psychologists and radiologists evaluated the scores obtained. Results: 83 out of 343 patients were excluded becaus…

Swallowing impairment in neurologic disorders: The role of videofluorographic swallowing study

Patients with neurologic diseases almost inevitably develop various degrees of swallowing disorders during their life. Dysphagia is one of the main negative prognostic factors in this class of patients, leading to severe morbidity (i.e. aspiration pneumonia, dehydration, malnutrition, and life quality deterioration) and to a noticeable increase in public health spending. Videofluorographic swallowing study is considered the gold standard technique for swallowing impairment assessment. It is aimed at early identification of the risk of aspiration, definition of the kind and grade of dysphagia, and an indication to suspend oral nutrition and adopt other feeding strategies, and define when the…

Hippocampal reversible lesions in a case of transient global amnesia

We report the case of 55-year-old man that after an emotional stress showed retrograde and anterograde amnesia with impairment of orientation in space and time but undisturbed consciousness. A neurological examination excluded other neurological signs or symptoms. The amnesic syndrome resolved spontaneously within 24 hours and the hypothesis of transient global amnesia was placed. Brain CT scan and conventional MRI sequences did not show any relevant pathological findings but diffusion-weighted imaging (DWI) showed two millimetric bright spot of restricted diffusion in the right hippocampus; in a brain MRI follow-up those findings were no more appreciable. The diagnosis of transient global …

Initial experiences in radiology e-learning

The use of two different educator-centric learning management systems (LMSs), Moodle and Manila, for radiology e-learning was formatively evaluated and the implications of the future use of LMSs in radiology education were explored. NeuroRAD, a neuroradiologic digital library and learning community, is implemented with Moodle, one of the most popular open-source educator-centric LMSs. Pediatric-Education.org, a pediatric digital library and learning community, is implemented with Manila, a commercial educator-centric LMS. Quantitative and qualitative analyses of these LMSs were performed with World Wide Web server log file statistical programs and user-submitted comment forms. In 2005, Neur…

Perfusion MR Imaging in Differentiating High-Grade from Low-Grade Gliomas

To correlate perfusion MR imaging with histologic grade of cerebral gliomas. Materials & Methods Relative cerebral blood volume (rCBV) maps were determined in 22 patients with pathologically proved gliomas (11 glioblastomas, 8 anaplastic gliomas and 2 low-grade gliomas) by dynamic contrast-enhanced T2*-weighted MR imaging. MR examination was completed with conventional T1- and T2-weighted imaging. The rCBV maps were calculated with an independent workstation by fitting a gamma-variate function to the contrast material concentration versus time curve. Relative CBV ratios obtained between tumor and normal white matter were compared between glioblastomas, anaplastic gliomas and low-grade gliom…

Choline PET/CT Features to Predict Survival Outcome in High Risk Prostate Cancer Restaging: A Preliminary Machine-Learning Radiomics Study

Background Radiomic features are increasingly utilized to evaluate tumor heterogeneity in PET imaging but to date its role has not been investigated for Cho-PET in prostate cancer. The potential application of radiomics features analysis using a machine-learning radiomics algorithm was evaluated to select 18F-Cho PET/CT imaging features to predict disease progression in PCa. Methods We retrospectively analyzed high-risk PCa patients who underwent restaging 18F-Cho PET/CT from November 2013 to May 2018. 18F-Cho PET/CT studies and related structures containing volumetric segmentations were imported in the "CGITA" toolbox to extract imaging features from each lesion. A Machine-learning model h…

Forensic investigation in aircraft accident with the aid of CT (MSCT), and Magnetic Resonance Imaging (MRI): our experience

The autors report their experience in a case of air disaster in which a Tuninter airlines ATR 72 fallen down into the sea near Capo Gallo coast (Palermo, Italy) with 39 persons on board, resulting in six-teen victims. In the present contribute the authors argued the causes of the death and analysed patternes of injuries sustained by passengers involved in the fatal airplane accident using the conventional autopsy combined with postmortem Multi Slice Computed Tomography (MSCT) examination.

Anatomia e patologia del labirinto membranoso studio con sequenze RM sensibili al flusso

Nonostante i deludenti esordi nella valutazione delle strutture labirintiche costituenti l'orecchio interno, la risonanza magnetica costituisce oggi, grazie anche al miglioramento dell'hardware e del software disponibili, una modalità diagnostica di grande efficacia non solo nell'analisi della patologia espansiva o infiammatoria coinvolgente il VII ed VIII nervo cranico, ma anche nella valutazione delle alterazioni patologiche del segnale endolabirintico in rapporto a focolai emorragici o, come recentemente dimostrato mediante uso di Gd-DTPA, nell'analisi delle alterazioni a carico della capsula oticanella fase spongiotica dell'otosclerosi. Tuttavia, lo scarso contrasto esistente tra liqui…

Focal nodular hyperplasia in normal and fatty liver: a qualitative and quantitative evaluation with contrast-enhanced ultrasound

The aim of this study was to describe gray-scale appearance of liver parenchyma and focal nodular hyperplasia (FNH) by pulse inversion (PI) ultrasound (US) at baseline and after contrast agent administration in patients with normal and fatty liver. Sixteen consecutive patients (12 women, 4 men) with 29 previously diagnosed FNHs (15 of 29 located in normal liver and 14 of 29 in fatty liver) underwent PI US before and after SH U 508A (Levovist) injection. Signal intensity values were measured within the FNHs and the adjacent liver parenchyma in selected images. Baseline echogenicity of fatty liver was higher (15.19 +/- 2.90 dB +/- SD) than normal liver (10.91 +/- 3.15 dB +/- SD; p<0.001). Aft…

CT and MR imaging of cystic renal lesions

AbstractCystic renal lesions are a common incidental finding on routinely imaging examinations. Although a benign simple cyst is usually easy to recognize, the same is not true for complex and multifocal cystic renal lesions, whose differential diagnosis includes both neoplastic and non-neoplastic conditions. In this review, we will show a series of cases in order to provide tips to identify benign cysts and differentiate them from malignant ones.

Whole body magnetic resonance in indolent lymphomas under watchful waiting: The time is now.

The indolent non-Hodgkin lymphomas (i-NHLs) are characterised by ‘indolent’ clinical behaviour with slow growth and prolonged natural history. The watchful waiting (WW) strategy is a frequently employed treatment option in these patients. This implies a strict monitoring by imaging examinations, including 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) and CT. A major concern is radiation exposure due to regularly monitoring by conventional imaging procedures. Several studies have demonstrated the reliability of whole-body magnetic resonance imaging (WB-MRI) for lymphoma staging. WB-MRI could be useful for active surveillance in i-NHLs providing the …

Hepatocellular and Fibrolamellar Carcinoma

G. Brancatelli, MD; M. Midiri, MD; R. Lagalla, MD Department of Radiology, Policlinico Universitario, Via del Vespro 127, 90127 Palermo, Italy M. P. Federle, MD Department of Radiology, Abdominal Imaging Offi ces, University of Pittsburgh Medical Center, Room 4660, CHP, MT, 200 Lothrop Street, Pittsburgh, PA 15213, USA V. Vilgrain, MD Department of Radiology, Hospital Beaujon, Avenue Du General Leclerc 100, 92118 Clichy, France L. Grazioli, MD Department of Radiology, University of Brescia, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25023 Brescia, Italy CONTENTS

Riscontro incidentale di noduli tiroidei: incidenza, aspetti B-mode e color Doppler in una popolazione adulta studiata con "real-time compound sonography"

Ernie della parete addominale ed ernie interne: ruolo della tcmd nella gestione clinica del paziente.

MR Signal Changes as Predictor of Pancreas Iron Overload and Impairment in Secondary Hemochromatosis

dc.description.abstract

Airway wall thickness by HRCT in patients with COPD.

Varianti anatomiche dell’albero coronarico visualizzate mediante angiografia coronarica con TC a 64 strati

Imaging of complications of muscle tears.

Vesicoureteral reflux in young patients: Comparison of voiding color Doppler US with echo enhancement versus voiding cystourethrography for diagnosis or exclusion

We assessed the accuracy of voiding color Doppler ultrasonography (US) with echo enhancement for diagnosis or exclusion of vesicoureteral reflux (VUR) versus voiding cystourethrography (VCUG) and evaluated patient tolerance of the echo-enhancing agent. One hundred twenty-two patients (ages range, 1 month to 17 years) with 244 ureterorenal units underwent voiding color Doppler US with echo enhancement, which was followed by VCUG on the same day. After US of the urinary tract, the bladder was filled with saline solution via catheter. Then an echo-enhancing agent was instilled, and color Doppler US was performed. Reflux was diagnosed when microbubbles appeared in the ureter or the pelvicalicea…

The Videofluorographic Swallowing Study in Rheumatologic Diseases: A Comprehensive Review

Autoimmune connective tissue diseases are a heterogeneous group of pathologies that affect about 10% of world population with chronic evolution in 20%–80%. Inflammation in autoimmune diseases may lead to serious damage to other organs including the gastrointestinal tract. Gastrointestinal tract involvement in these patients may also due to both a direct action of antibodies against organs and pharmacological therapies. Dysphagia is one of the most important symptom, and it is caused by failure of the swallowing function and may lead to aspiration pneumonia, malnutrition, dehydration, weight loss, and airway obstruction. The videofluorographic swallowing study is a key diagnostic tool in the…

Automatic multi-seed detection for MR breast image segmentation

In this paper an automatic multi-seed detection method for magnetic resonance (MR) breast image segmentation is presented. The proposed method consists of three steps: (1) pre-processing step to locate three regions of interest (axillary and sternal regions); (2) processing step to detect maximum concavity points for each region of interest; (3) breast image segmentation step. Traditional manual segmentation methods require radiological expertise and they usually are very tiring and time-consuming. The approach is fast because the multi-seed detection is based on geometric properties of the ROI. When the maximum concavity points of the breast regions have been detected, region growing and m…

EVALUATION OF MESENTERIC CHANGES WITH ELASTOSONOGRAPHY AND DIFFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING IN PATIENTS WITH CROHN'S DISEASE: PRELIMINARY RESULTS

Aims and objectives Methods and materials Results Conclusion Personal information References

Cirrhosis: CT and MR imaging evaluation

In this article, we present the CT and MR imaging characteristics of the cirrhotic liver. We describe the altered liver morphology in different forms of viral, alcoholic and autoimmune end-stage liver disease. We present the spectrum of imaging findings in portal hypertension, such as splenomegaly, ascites and varices. We describe the patchy and lacelike patterns of fibrosis, along with the focal confluent form. The process of hepatocarcinogenesis is detailed, from regenerative to dysplastic nodules to overt hepatocellular carcinoma. Different types of non-neoplastic focal liver lesions occurring in the cirrhotic liver are discussed, including arterially enhancing nodules, hemangiomas and p…

Imaging findings of hepatic Focal Nodular Hyperplasia (FNH) in Gadoxetic Acid vs Gadobenate Dimeglumine-enhanced MR: preliminary results

Aspetti delle lesioni cistiche epatiche con TC ed RM obiettivi

Virtual bronchoscopy in patients with central endobronchial stenosing lesions. Technique optimisation with single slice spiral CT.

PURPOSE: To describe an original protocol for single slice spiral Computed Tomography (CT) virtual bronchoscopy in the evaluation of patients with central airway stenoses and compare the results with fibreoptic bronchoscopy. MATERIALS AND METHODS: Ten patients (4 female and 6 male; age range 22-60 years; mean age 44 years) with endobronchial disease diagnosed by fibreoptic bronchoscopy (8 malignant tumours, 1 benign tumour and 1 fibroid stenosis) underwent virtual bronchoscopy with single slice spiral CT. A panoramic spiral CT scan of the whole chest was first obtained. Once the area of interest had been identified, a new contrast enhanced scan was performed, from bottom to top, with the fo…

Tumori gastrointestinali stromali: Aspetti con tomografia computerizzata multidetettore (40-strati)

Purpose. The purpose of this study was to describe the findings and evaluate the role of multidetector (40-slice) computed tomography (MDCT) in the preoperative assessment of gastrointestinal stromal tumours (GISTs). Materials and methods. Thirteen patients with histologically proven GIST (size: 4-30 cm; mean: 9 cm) underwent 40-slice MDCT after the ingestion of 1,000 ml of water. Images were obtained before and 70 s after intravenous injection of 120 ml of iodinated contrast agent. Two experienced radiologists reviewed the CT findings to evaluate lesion site, size, margins, attenuation, growth pattern, enhancement pattern, ascites, lymphadenopathy, direct invasion to adjacent organs and di…

Effects of the static magnetic field generated by 0.5 T MRI unit on human CD4+ T cells activation patterns.

Incidence of new foci of Hepatocellular Carcinoma in patients who underwent radiofrequency ablation of Hepatocellular Carcinoma: Role of MDCT

Whole-body magnetic resonance imaging and FDG-PET/CT for lymphoma staging: Assessment of patient experience

Purpose: To compare patient experience of whole-body MRI and FDG-PET/CT performed for lymphoma staging. Methods: One-hundred-fifteen patients (59 males, 56 females; 53 Hodgkin, 62 non-Hodgkin; mean age: 43.8 years) with lymphoma underwent whole-body MRI and FDG-PET/CT for staging and filled a questionnaire regarding their experience of the examinations using a 4-point Likert scale (1, very good; 4,very bad). Differences were evaluated using Wilcoxon signed-rank test. Patients were asked to express their preference on both techniques. Preferences were compared on the basis of gender, age, and Ann Arbor stage using the chi-square test. A p-value ≤ .05 was considered significant. Results: Most…

Profilo di accettabilità dell’angiografia coronarica non invasiva mediante TC Multistrato: per una medicina dalla parte del paziente

tiroide diagnostica per immagini e approccio clinico ragionato

EFFECTS OF THE STATIC MAGNETIC FIELD GENERATED BY 0.5 T MRI UNIT ON INTRACELLULAR CALCIUM CONCENTRATION AND TNF-ALPHA RELEASE OF HUMAN MACROPHAGES

The Role of Magnetic Resonance Imaging in Central Hearing Deficits: Beyond the Acoustic Schwannoma

Acoustic schwannoma is assumed to be the most common cause of sensory-neural hearing loss (SNHL), and many papers have described the role of magnetic resonance imaging (MRI) in the diagnosis of cerebello-pontine angle (CPA) tumours, particularly schwannoma. We retrospectively examined 72 patients complaining of different clinical syndromes and SNHL or different kinds of acoustic impairment who underwent MRI brain study excluding the presence of acoustic schwannoma and other CPA masses. In conclusion, although acoustic schwannoma is the most common cause of acquired HD, a lesion involving the neural centers of the acoustic pathway can also determine SNHL or HD. Considering the high sensitiv…

Indeterminate focal liver lesions incidentally discovered at gray-scale US: role of contrast-enhanced sonography.

OBJECTIVES: to assess the role of contrast-enhanced ultrasound (CEUS) in the characterization of focal liver lesions (FLLs) incidentally discovered but indeterminate at gray-scale ultrasound (US). MATERIALS AND METHODS: one hundred forty-two consecutive patients with 174 FLLs (169 benign and 5 malignant) incidentally discovered but indeterminate at gray-scale US, underwent CEUS after the administration of SonoVue. Two readers independently reviewed CEUS scans and: (1) classified each lesion as malignant or benign on a 5-point scale of confidence by means of definite diagnostic criteria; (2) provided if possible a specific diagnosis; (3) were requested if further imaging was needed for lesio…

Imaging findings of hepatic focal nodular hyperplasia in men and women: are they really different?

Purpose This study was undertaken to compare the imaging findings of focal nodular hyperplasia (FNH) in men and women, as seen on multidetector computed tomography (MDCT), magnetic resonance imaging (MRI) and contrast-enhanced ultrasound (CEUS). Materials and methods Two radiologists reviewed 195 imaging studies (17 MDCT, 81 MRI and 97 CEUS examinations) pertaining to 111 FNHs (mean size 3 cm) in 91 patients (mean age 39 years). For each lesion, the readers assessed size, location, echogenicity, attenuation, or signal intensity in comparison with adjacent liver parenchyma on both unenhanced and postcontrast images. Results Eighty-nine FNHs (mean size 3.1 cm) were observed in 73 women (mean …

ESAME RADIOLOGICO DEL TORACE NELL’INVECCHIAMENTO CARDIACO

Sviluppo di un server DICOM a basso costo ai fini didattici e di ricerca

Low bone mineral density in HIV-positive young Italians and migrants.

Background Human immunodeficiency virus (HIV) infected individuals may have osteoporosis. We aimed to evaluate the bone mineral density (BMD) in naïve antiretroviral (ARV) treated HIV positive patients comparing native Italian group (ItG) to a Migrants group (MiG) upon arrival in Italy. Methods We conducted a cross-sectional study on 83 HIV patients less than 50 years old. We used the dual-energy X-ray absorptiometry (DXA) within six months from the HIV diagnosis. Participants were categorized as having low BMD if the femoral neck or total lumbar spine Z-score was– 2 or less. Results MiG showed low BMD more often than ItG (37.5% vs.13.6%), especially for the female gender (16.7% vs. 0.0%). …

Enhancement pattern of small hepatocellular carcinoma (HCC) at contrast-enhanced US (CEUS), MDCT, and MRI: intermodality agreement and comparison of diagnostic sensitivity between 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines

OBJECTIVE:To evaluate agreement between contrast-enhanced ultrasound (CEUS), multi-detector row computed tomography (MDCT) and magnetic resonance imaging (MRI) for the assessment of typical and atypical enhancement patterns of small hepatocellular carcinoma (HCC); and to compare diagnostic sensitivity of 2005 and 2010 American Association for the Study of Liver Diseases (AASLD) guidelines. MATERIALS AND METHODS: Between January 2008 and December 2009, we included cirrhotic patients with newly diagnosed 10-20 mm HCC imaged at two contrast-enhanced imaging techniques among CEUS, MDCT, and MRI. Dynamic studies were reviewed by two radiologists to assess enhancement pattern. Percentage of cases…

Cirrhosis: CT and MR imaging evaluation.

In this article, we present the CT and MR imaging characteristics of the cirrhotic liver. We describe the altered liver morphology in different forms of viral, alcoholic and autoimmune end-stage liver disease. We present the spectrum of imaging findings in portal hypertension, such as splenomegaly, ascites and varices. We describe the patchy and lacelike patterns of fibrosis, along with the focal confluent form. The process of hepatocarcinogenesis is detailed, from regenerative to dysplastic nodules to overt hepatocellular carcinoma. Different types of non-neoplastic focal liver lesions occurring in the cirrhotic liver are discussed, including arterially enhancing nodules, hemangiomas and p…

Transfusional Hemochromatosis: Quantitative Relation of MR Imaging Pituitary Signal Intensity Reduction to Hypogonadotropic Hypogonadism

To assess the relationship between magnetic resonance (MR) imaging pituitary signal intensity reduction in patients with transfusional hemochromatosis and the clinical manifestation of hypogonadotropic hypogonadism.Pituitary MR imaging at 0.5 T was performed in 38 consecutive patients affected by secondary hemochromatosis and in 20 healthy volunteers. Serum ferritin levels were estimated in the affected population. Twenty (53%) of the 38 patients had hypogonadotropic hypogonadism diagnosed. Pituitary-to-fat signal intensity ratios were calculated from coronal gradient-echo (GRE) T2*-weighted MR images. The relationship between the quantitative reduction of the pituitary-to-fat signal intens…

Idiopathic intracranial hypertension: orbital MRI

The case is reported of a patient with idiopathic intracranial hypertension examined with magnetic resonance imaging. Marked enhancement of the optic nerve heads was found, which might be related to blood-retinal barrier breakdown related to a sudden rise in intracranial cerebrospinal fluid pressure.

Focal liver lesions hyperintense on T1-weighted magnetic resonance images.

This article reviews focal liver lesions hyperintense on T1-weighted magnetic resonance (MR) images and describes the underlying etiologies associated with their T1 signal intensity. Although focal liver lesions are commonly detected because of their iso- or hypointensity on T1-weighted images, lesions (benign or malignant) may present with T1 hyperintensity when they contain T1 shortening elements--such as fat, hemorrhage, copper, melanin, and highly concentrated proteins. Our discussion includes the description of state-of-the-art T1-weighted MR sequences and the imaging features of lesions on pre- and postcontrast MR images that are characteristic for lesion composition and useful for ma…

CT and MR Imaging Evaluation of Hepatic Adenoma

Hepatic adenoma is a rare benign epithelial tumor that is usually encountered in young women who use oral contraceptives. It is clinically significant because of the risk of hemorrhage and of its low-grade malignancy potential. Adenomas usually are mildly hypervascular at contrast-enhanced CT and MR imaging, and heterogeneous due to the presence of hemorrhage, necrosis, calcifications and fat. The objective of our study was to illustrate the CT and MR imaging findings of hepatic adenoma.

Role of high-resolution ultrasonography without and with real-time spatial compound imaging in evaluating the injured posterior cruciate ligament: preliminary study.

This study sought to compare high-resolution ultrasonography (HRUS) without and with compound imaging in evaluating the injured posterior cruciate ligament (PCL). Thirteen patients with a magnetic resonance imaging (MRI) diagnosis of PCL lesions (ten acute and three chronic) and 20 healthy controls underwent conventional and compound HRUS performed by the same radiologist who was blinded to the subjects' case-control status. The PCL was scanned in a longitudinal direction in all cases. HRUS images were assessed for PCL thickness by two other radiologists blinded to the number and type of PCL injury. PCLs were classified as normal or injured, and the latter as having acute or chronic injurie…

MR Imaging of Perianal Crohn Disease: The Role of Contrast-enhanced Sequences

The MR imaging protocol described by the authors includes contrast-enhanced T1-weighted imaging with fat saturation in all patients except those with poor renal function. Horsthuis et al demonstrated in 2009 the usefulness of contrast-enhanced MR imaging for determining disease activity. Contrast agent administration is also required in case of suspicion of neoplastic tissue complicating fistulas. The joint European Crohn’s and Colitis Organisation–European Society of Gastointestinal and Abdominal Radiology guidelines report that T2-weighted images and contrast-enhanced T1-weighted images are included in the MR imaging protocol for the evaluation of perianal CD. However, as we have demonstr…

TCMD a 64 canali nell’occlusione intestinale meccanica acuta: ricostruzioni multiplanari versus immagini assiali

Application of an intelligent study and research support system for clinical anatomy in a cooperation scenario

Scientific research and teaching are strongly interrelated. A student should be educated both to the fundamentals of a discipline and to the research tasks as the future development of a discipline is entrusted to the students of today. Computer based tutoring systems already showed useful in pursuing the former target while the Intelligent Study and Research Support System developed at DINFO may be used to fulfill both in an integrated manner. This paper introduces the possible application of the ISRSS to training of Clinical Anatomy in a scenario of international cooperation among academic institutions.

Contrast agent and thyroid gland

Comparison of US Strain Elastography and Entero-MRI to Typify the Mesenteric and Bowel Wall Changes during Crohn’s Disease: A Pilot Study

Purpose. To evaluate and compare the mesenteric and bowel wall changes during Crohn’s disease (CD) on ultrasonography (US) Strain Elastography (SE) and Enterography Magnetic Resonance Imaging (E-MRI). Methods. From July 2014 to September 2016, 35 patients with ileocolonoscopy diagnosis of CD were prospectively examined with E-MRI and in the same time with US and SE. Results. A total of 41 affected bowel segments and 35 unaffected bowel segments in 35 patients were evaluated. US-SE color-scale coding showed a blue color pattern in the fibrotic mesentery and bowel wall in 15 patients and a green color pattern in the edematous ones in 20 patients. The signal of the bowel wall and mesenteric fa…

Angiomi epatici atipici all’ecografia di base: caratterizzazione con ecografia ad inversione di impulso e SonoVue

Post-mortem Foetal Imaging

The gold standard for the diagnosis of foetal death is known to be the autopsy examination, which is sometimes supplemented by chromosomal and/or genetic studies. Nevertheless, autopsy rates are continuously declining, due to multifactorial and complex reasons, even anatomical, social and psychological ones, thus impacting the rate of radiological post-mortem foetal examinations.

Broncoscopia virtuale in pazienti con lesioni endobronchiali stenosanti. Ottimizzazione della tecnica con TC spirale monostrato

PURPOSE: To describe an original protocol for single slice spiral Computed Tomography (CT) virtual bronchoscopy in the evaluation of patients with central airway stenoses and compare the results with fibreoptic bronchoscopy. MATERIALS AND METHODS: Ten patients (4 female and 6 male; age range 22-60 years; mean age 44 years) with endobronchial disease diagnosed by fibreoptic bronchoscopy (8 malignant tumours, 1 benign tumour and 1 fibroid stenosis) underwent virtual bronchoscopy with single slice spiral CT. A panoramic spiral CT scan of the whole chest was first obtained. Once the area of interest had been identified, a new contrast enhanced scan was performed, from bottom to top, with the fo…

Color doppler ultrasonography of soft-tissue masses

Purpose: To evaluate the capability of color Doppler ultrasonography to differentiate between benign and malignant soft-tissue tumors. Material and Methods: We reviewed the ultrasonographic (US) and color Doppler (CD) findings in 46 consecutive patients with a palpable periskeletal mass. The presence of 3 or more vascular hila and of tortuous and irregular internal vessels within the lesions was considered an indication of malignancy. The CD diagnosis was compared with that obtained at US alone. Results: The sensitivity and specificity of CD were respectively 85% and 92%; these values were higher than those obtained at US alone, respectively 75% and 50%. Arteriovenous malformations present…

Radiomics analysis of 18F-Choline PET/CT in the prediction of disease outcome in high-risk prostate cancer: an explorative study on machine learning feature classification in 94 patients

Objective: The aim of this study was (1) to investigate the application of texture analysis of choline PET/CT images in prostate cancer (PCa) patients and (2) to propose a machine-learning radiomics model able to select PET features predictive of disease progression in PCa patients with a same high-risk class at restaging. Material and methods: Ninety-four high-risk PCa patients who underwent restaging Cho-PET/CT were analyzed. Follow-up data were recorded for a minimum of 13 months after the PET/CT scan. PET images were imported in LIFEx toolbox to extract 51 features from each lesion. A statistical system based on correlation matrix and point-biserial-correlation coefficient has been impl…

Superior Mesenteric Artery Syndrome: Clinical, Endoscopic, and Radiological Findings.

Background. The superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss. Studies to determine the optimal methods of diagnosis and treatment are required. Aims and Methods. This study aims at analyzing the clinical presentation, diagnosis, and management of SMA syndrome. Ten cases of SMA syndrome out of 2074 esophagogastroduodenoscopies were suspected. A contrast-enhanced computed tomography (CECT) scan was performed to confirm the diagnosis. After, a gastroenterologist and a nutritionist personalized the therapy. Furthermore, we compared the demographical, clinical, endoscopic, and radiological parameters of these …

Role of virtopsy in the post-mortem diagnosis of drowning.

Purpose: Due to admitted limits of autopsy-based studies in the diagnosis of drowning, virtopsy is considered the new imaging horizon in these post-mortem studies. The aim of our study was to evaluate the role of virtopsy performed through computed tomography (CT) in the forensic diagnosis of drowning. Materials and methods: We retrospectively examined the CT data of four cadavers recovered from sea water and suspected to have died by drowning. Each patient underwent a full-body post-mortem CT scan, and then a traditional autopsy. Conclusion: To date, there are no autopsy findings pathognomonic of drowning. This study proves that virtopsy is a useful tool in the diagnosis of drowning in tha…

Diagnostica per immagini dell’epatocarcinoma

TIROIDE

Imaging assessment of paediatric Crohn's disease: A literature review

Owing to the frequent absence of specific symptoms, diagnosis of Crohn's disease may be delayed, potentially leading to important patient morbidity, growth failure, pubertal delay, or a complicated form of the disease. In paediatric patients with Crohn's disease, radiation protection requires special consideration, and choosing the most appropriate imaging modality is crucial. All radiologists should be familiar with the main imaging characteristics of Crohn's disease. Therefore, the present study reviews the current literature on imaging modalities and main imaging characteristics of Crohn's disease. Magnetic resonance imaging is recommended for diagnosis of Crohn's disease in paediatric p…

Hepatocellular cancer response to radiofrequency tumor ablation: contrast-enhanced US

Incidence of new foci of hepatocellular carcinoma (HCC) in patients who underwent radiofrequency ablation of HCC: Role of multidetector CT

Focal breast lesion characterization according to the BI-RADS US lexicon: role of a computer-aided decision-making support

Objectives: to assess the diagnostic performance of a computer-guided decision- making software (S-Detect) in the US characterization of focal breast lesions (FBLs), according to the radiologist's experience. Materials and Methods: 300 FBLs (size: 2.6-47.2 mm; mean: 13.2 mm) in 255 patients (mean age: 51 years) were prospectively assessed in consensus according to BIRADS US lexicon by two experienced radiologists without and with S-Detect; to evaluate intra and inter-observer agreement, the same 300 FBLs were independently evaluated by two residents at baseline and after 3 months. Results: 120/300 (40%) FBLs were malignant, 2/300 (0.7%) high-risk and 178/300 (59.3%) benign. Experts review s…

Postmortem Computed Tomography: From Acquisition to Reporting

PMCT in a noninvasive, fast, and quite available method which coroners and forensic experts tend to use more and more often, especially when a crime is suspected. PMCT proved to be an excellent tool for detection and assessment of bone fracture injuries due to sharp trauma and bullet trajectories.

Acute traumatic acromionclavicular jointlesions: role of ultrasound versus conventional radiography

Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept

Background. To compare sensitivity of unenhanced computed tomography (CT) and contrast-enhanced CT for the identification of the etiology of bowel obstruction.Materials and Methods. We retrospectively evaluated abdominal CT scans of patients operated for bowel obstruction from March 2013 to October 2017. Two radiologists evaluated CT scans before and after contrast agent in two reading sessions. Then, we calculated sensitivity of CT in the diagnosis of bowel obstruction and determined in which cases the etiology of bowel obstruction was detected on both unenhanced and enhanced CT or on enhanced CT only. The reference standard was defined as the final diagnosis obtained after surgery.Results…

Effects of the static magnetic field generated by 0.5 T MRI unit on intracellular calcium concentration and TNF-α release of human macrophages

causes of false positive interpretation for hepatocellular carcinoma in cirrhosis

Principi tecnici ed applicazioni dei filtri di ricostruzione in angiografia coronarica mediante TC Multistrato

Focal liver lesions hyperintense on T1-weighted magnetic resonance images

This article reviews focal liver lesions hyperintense on T1-weighted magnetic resonance (MR) images and describes the underlying etiologies associated with their T1 signal intensity. Although focal liver lesions are commonly detected because of their iso- or hypointensity on T1-weighted images, lesions (benign or malignant) may present with T1 hyperintensity when they contain T1 shortening elements--such as fat, hemorrhage, copper, melanin, and highly concentrated proteins. Our discussion includes the description of state-of-the-art T1-weighted MR sequences and the imaging features of lesions on pre- and postcontrast MR images that are characteristic for lesion composition and useful for ma…

Collateral non cardiac findings in clinical routine CT coronary angiography: results from a multi-center registry.

Purpose: The aim of the study was to evaluate the prevalence of collateral findings detected in computed tomography coronary angiography (CTCA) in a multi-center registry. Materials and methods: We performed a retrospective review of 4303 patients (2719 males, mean age 60.3 ± 10.2 years) undergoing 64-slice CTCA for suspected or known coronary artery disease (CAD) at various academic institutions between 01/2006 and 09/2010. Collateral findings were recorded and scored as: non-significant (no signs of relevant pathology, not necessary to be reported), significant (clear signs of pathology, mandatory to be reported), or major (remarkable pathology, mandatory to be reported and further invest…

Riempimento centrifugo (”inside-out”) degli angiomi epatici: un possibile e atipico aspetto all’ecografia con mezzo di contrasto

Glioma Grading: The Role of Combined Perfusion MR Imaging and Single-Voxel MR Spectroscopy Compared to Conventional MR Imaging

Abstract Body: Purpose To assess the contribution of combined perfusion MR imaging (MRI) and single-voxel MR spectroscopy (MRS) in grading primary gliomas compared with conventional MRI. Materials & Methods Thirty-two patients with primary cerebral glioma underwent conventional MRI, dynamic contrast-enhanced T2*-weighted perfusion MRI and single-voxel proton MRS. Gliomas were graded as low or high based on conventional MRI. The rCBV measurements were obtained from regions of maximum perfusion normalized between tumor and healthy tissue. Metabolite ratios ( [Cho]/[Cr], [Cho]/[NAA], [NAA]/[Cr]) were measured with TE: 34 ms. Tumor grade determined with the three methods then was compared with …

Atypical liver hemangiomas: contrast enhancement patterns with SH U 508A and pulse inversion ultrasound

Ruolo della RM whole body nell’identificazione di reperti incidentali in pazienti con linfoma.

Scopo: Il dibattito in merito ai reperti incidentali sta divenendo emergente in molti settori radiologici, quali l’ambico cardiaco, addominale, neurologico, senologico, pediatrico, soprattutto con metodiche quali la RM e la TC. Lo scopo del nostro studio è stato di valutare l’utilità della Risonanza Magnetica Whole Body (RM-WB) nell’identificazione di reperti incidentali in pazienti con linfoma. Materiali e metodi: Sono state revisionate le RM-WB eseguite su 114 pazienti (65 maschi; età mediana 45,2 anni, range 15-86) con diagnosi istologica di linfoma (47 Hodgkin, 67 Non-Hodgkin). I reperti incidentali sono stati classificati in tre classi: non significativi (classe 1), moderatamente signi…

Profilo di accettabilità dell'angiografia coronarica non invasiva mediante TC multistrato: per una medicina dalla parte del paziente.

The cheating liver: imaging of focal steatosis and fatty sparing

ABSTRACT: Focal steatosis and fatty sparing are a frequent finding in liver imaging, and can mimic solid lesions. Liver regional variations in the degree of fat accumulation can be related to vascular anomalies, metabolic disorders, use of certain drugs or coexistence of hepatic masses. CT and MRI are the modalities of choice for the noninvasive diagnosis of hepatic steatosis. Knowledge of CT and MRI appearance of focal steatosis and fatty sparing is crucial for an accurate diagnosis, and to rule-out other pathologic processes. This paper will review the CT and MRI techniques for the diagnosis of hepatic steatosis and the CT and MRI features of common and uncommon causes of focal steatosis …

Osteonecrosis detected by whole body magnetic resonance in patients with Hodgkin Lymphoma treated by BEACOPP

Objectives: The purpose of our retrospective review of prospectively acquired Whole Body Magnetic Resonance (WB-MRI) scans was to assess the incidence of osteonecrosis in patients who received different chemotherapies. Methods: We evaluated the WB-MRI scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6ABVD, 2ABVD + 4BEACOPP, 2ABVD + 8BEACOPP), excluding patients with the main risk factors for osteonecrosis. Results: Six out of seven patients (86 %) who received eight BEACOPP and one out of five patients (20 %) treated by four BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients…

Nuove prospettive dell’imaging tiroideo : ecografia con mezzo di contrasto

Analisi della funzione ventricolare sinistra (FVS) in cardio-TC: influenze dell’intervallo di ricostruzione e dello spessore di strato sull’accuratezza diagnostica e sul time-consuming

Chest CT in COVID-19 Pneumonia: Potentials and Limitations of Radiomics and Artificial Intelligence

SARS-CoV-2 epidemics has resulted in an unprecedented global health crisis causing a high number of deaths with pneumonia being the most common manifestation. Chest CT is the best imaging modality to identify pulmonary involvement, but unfortunately there are no pathognomonic features for COVID-19 pneumonia, since many other infectious and non-infectious diseases may cause similar alterations. The adoption of artificial intelligence in biomedical imaging has the potential to revolutionize the identification, management, and the patient’s outcome. If adequately validated, it could be used as a support with predictive and prognostic purposes in symptomatic patients but also as a screening tes…

ECG-GATED MULTIDETECTOR COMPUTED TOMOGRAPHY FOR THE ASSESSMENT OF THE POSTOPERATIVE ASCENDING AORTA

This study was undertaken to define the role of electrocardiographically (ECG)-gated multidetector computed tomography (MDCT) in the assessment of the postoperative ascending aorta. From November 2006 to June 2007, 21 patients, [11 men, ten women; age +/- standard deviation (SD): 62.7 +/- 10.8 years] with a history of ascending aorta replacement underwent ECG-gated MDCT and were prospectively included in our study. Ascending aorta replacement had been performed with different surgical techniques: Bentall-De Bono (four patients, 19%), Tirone-David (five patients, 23%), and modified Tirone-David with creation of aortic neosinuses (12 patients, 57%). Two patients were excluded from MDCT evalua…

CONTRIBUTO DELLA RM PERFUSIONALE IN ASSOCIAZIONE ALLA SPETTROSCOPIA RM SINGLE VOXEL NELLA DEFINIZIONE DEL GRADING DEI GLIOMI CEREBRALI.

PREVALENCE OF MYOCARDIAL BRIDGING AND CORRELATION WITH CORONARY ATHEROSCLEROSIS STUDIED WITH 64-SLICE CT CORONARY ANGIOGRAPHY

Gd-DTPA in blood-ocular barrier damage: a new diagnostic tool for future application in MRI?

The blood-brain barrier is not the only neuroepithelial blood filter in the body: the eye too is supported by a highly specialised microvascular filter, the so-called blood-ocular barrier (BOB). The BOB is actually divided into a blood-aqueous (BAB) and a blood-retinal (BRB) barrier, filtering the aqueous fluid and biological supplies, respectively, to the retina. The authors’ purpose was to study the possibility of imaging BAB or BRB damage by contrast-enhanced MRI: they examined 21 patients with a 0.5 T system and surface coil. Despite the normal findings in the damaged eyes immediately after a Gd-DTPA bolus, delayed contrast-enhanced MRI was able to show focal or diffuse barrier damage.

A Brief History of Forensic Radiology

During the last two decades, forensic radiology showed, as never before, a rapid, widely diffuse, and substantial change in the legal, medical, anthropological, archaeological, and scientific approach to applications of forensic radiology itself.

Transcranial magnetic resonance imaging-guided focused ultrasound treatment at 1.5 T: a retrospective study on treatment and patient-related parameters obtained from 52 Procedures

Objective: To present a retrospective analysis of patient- and sonication-related parameters of a group of patients treated with a transcranial magnetic resonance imaging (MRI)-guided focused ultrasound (tcMRgFUS) system integrated with a 1.5-T MRI unit. Methods: The data obtained from 59 patients, who underwent the tcMRgFUS procedure from January 2015 to April 2019, were retrospectively reviewed for this study. The following data, among others, were mainly collected: skull density ratio (SDR), skull area (SA), number of available transducer elements (Tx), and estimated focal power at target (FP). For each of the four different treatment stages, we calculated the number of sonication proces…

Whole-Body Magnetic Resonance Imaging: Current Role in Patients with Lymphoma.

Imaging of lymphoma is based on the use of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) and/or contrast-enhanced CT, but concerns have been raised regarding radiation exposure related to imaging scans in patients with cancer, and its association with increased risk of secondary tumors in patients with lymphoma has been established. To date, lymphoproliferative disorders are among the most common indications to perform whole-body magnetic resonance imaging (MRI). Whole-body MRI is superior to contrast-enhanced CT for staging the disease, also being less dependent on histology if compared to 18F-FDG-PET/CT. As well, it does not require exposure to i…

Magnetic resonance imaging of the cirrhotic liver in the era of gadoxetic acid.

Gadoxetic acid improves detection and characterization of focal liver lesions in cirrhotic patients and can estimate liver function in patients undergoing liver resection. The purpose of this article is to describe the optimal gadoxetic acid study protocol for the liver, the unique characteristics of gadoxetic acid, the differences between gadoxetic acid and extra-cellular gadolium chelates, and the differences in phases of enhancement between cirrhotic and normal liver using gadoxetic acid. We also discuss how to obtain and recognize an adequate hepatobiliary phase.

Splenic hemangiomas: contrast-enhanced sonographic findings

Objectives The purpose of this study was to illustrate the baseline appearance and enhancement patterns of splenic hemangiomas on contrast-enhanced sonography. Methods Two experienced radiologists retrospectively reviewed by consensus baseline and contrast-enhanced sonographic examinations of 27 patients (14 women and 13 men; mean age, 58.7 years) with 27 splenic hemangiomas (mean size, 2 cm) confirmed by splenectomy, biopsy, computed tomography, and magnetic resonance imaging and follow-up. Results On baseline sonography, 77.8% of the lesions showed a homogeneous echo texture that was mainly hyperechoic. Color Doppler imaging did not show any signal in 81.5% of the cases. After contrast ag…

Calibro dei sifoni carotidei e asimmetria del poligono di Willis: Studio Angio-RM

A differenza dell'Angiografia, l'esame Angio-RM consente la simultanea visualizzazione dei vasi del poligono. Si è valutata la correlazione esistente tra calibro dei sifoni e asimmetrie di sviluppo del poligono nella popolazione normale. Sono stati esaminati 3 casi di occlusione totale di una carotide. 120 pazienti privi di patologie vascolari o neoplastiche sono stati sottoposti ad esame Angio-RM 3DTOF con Magnetization Tranfer e TONE. Sono state valutate le immagini di sorgente e 3DMIP, prima e dopo sottrazione dei pixel non vascolari. I pazienti sono stati suddivisi in 5 gruppi: I = aplasia di A1, II = ipoplasia di A1, III = lieve asimmetria di A1, IV ? arteria comunicante posteriore fe…

Contrast-enhanced ultrasound of hepatocellular carcinoma: where do we stand?

Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in ultrasonography (US), and it is being increasingly used for the evaluation of focal liver lesions (FLLs). CEUS is unique in that it allows non-invasively assessment of liver perfusion in real time throughout the vascular phase, which has led to dramatic improvements in the diagnostic accuracy of US in the detection and characterization of FLLs, the choice of therapeutic procedures, and the evaluation of response. Currently, CEUS is included as a part of the suggested diagnostic work-up of FLLs, including in cirrhotic patients with hepatocellular carcinoma, resulting in better patient management and cost-effective d…

Non-alcoholic Wernicke's encephalopathy: From MRI findings of a case to differential diagnosis checklist

Wernicke's encephalopathy is a serious neurological disorder secondary to thiamine deficiency in alcoholics. However, rarely it affects non-alcoholics. Here we present a case of Wernicke's encephalopathy in a non-alcoholic 56-year-old female, treated by endoscopic surgery for a duodenal ulcer two years before. She came to our attention for a sudden onset of a neurological syndrome characterized by visual deficits, diplopia, confusion, spatial disorientation and loss of short-term memory. An MRI scan showed the typical MRI findings of Wernicke's encephalopathy, which are discussed together with the possible differential diagnosis.

Ventrolateral Compression of the Brain Stem in Essential Hypertension: MR Angiography Study

Our purpose was to evaluate neurovascular compression at the level of ventrolateral medulla and NVC with the IXth and the Xth cranial nerves in patients with essential hypertension and in healthy volunteers using high resoluted Spoiled Recalled Gradient Echo (SPGR) sequences, allowing the detection of stationary tissues and moving spins. Thirty patients (19 men and 11 women) with essential hypertension were examined. Patient's ages ranged from 24 to 64 years-old (mean age was 48 y.o.). Patients older than 65 were excluded. The average of systolic blood-pressure of hypertensive patients was 183 ± 10 mmHg, while the diastolic pressure was 98 ± 10.5 mmHg. In conclusion, we consider axial sing…

Acceptance of non-invasive Multislice CT Coronary Angiography: is it a real patient-friendly technique?

The use of contrast-enhanced ultrasonography in the diagnosis and follow-up of Crohn's Disease

Qualitative and quantitative evaluation of solitary thyroid nodules with contrast-enhanced ultrasound: initial results

To assess the feasibility of contrast-enhanced ultrasound (CEUS) of the thyroid gland and to evaluate the potential of this method for characterising solitary thyroid nodules.18 patients affected by solitary thyroid nodules (size range: 0.6 to 3.6 cm; mean: 1.8 cm) confirmed by surgery (nine papillary carcinomas, four follicular carcinomas, three hyperplasias, one follicular adenoma and one Plummer’s adenoma) underwent pulse inversion US at low M.I. (0.06 to 0.08) after i.v. injection of a 2.4-mL bolus of SonoVue. Baseline echogenicity and the dynamic enhancement pattern of each nodule, in comparison with adjacent thyroid parenchyma, were assessed. Signal intensity values on grey-scale imag…

64-detector computed tomography in preoperative assessment of vascular anatomy of middle colic artery in left-sided colon cancer

Studio preliminare di parcellizzazione talamica per l’identificazione del target di trattamento applicato alle talamotomie trans-craniche mediante ultrasuoni focalizzati guidati da Risonanza Magnetica (tcMRgFUS) [Thalamic parcelization for target identification in trans-cranial MR-guided Focused UltraSound (tcMRgFUS) thalamotomies: a preliminary study]

Introduzione La tcMRgFUS consente di effettuare una vera e propria esplorazione neurofunzionale per confermare ed ottimizzare il target lesionale prima di indurre una lesione cerebrale permanete. La scelta del target di trattamento si basa tuttavia su coordinate stereotassiche che non tengono conto delle diversità anatomiche di ciascun individuo. L'ottimizzazione del target di trattamento viene effettuata sulla base del feedback del paziente durante la procedura stessa. Materiali e metodi È’ stato utilizzato uno scanner RM da 1.5T per acquisire sequenze morfologiche 3D e ultrastrutturali (DTI) in pazienti successivamente sottoposti a tcMRgFUS. È stata effettuata una segmentazione delle aree…

The focused assessment of trauma using ultrasonography (FAST)

Il referto in angiografia coronarica con TC a 64 strati: una nuova sfida per il radiologo

Videofluorography swallow study of patients with systemic sclerosis

PURPOSE: This study was undertaken to evaluate the role of the videofluorographic (VFG) swallow study in patients with systemic sclerosis. MATERIALS AND METHODS: Over a 23-month period, 45 women (mean age 58 years, range 27-76 years) with a known diagnosis of systemic sclerosis and a history of dysphagia underwent a dynamic and morphological study of the oral, pharyngeal and oesophageal phases of swallowing with videofluorography. All examinations were performed with a remote-controlled digital C-arm device with 16-in image intensifier, 0.6- to 1.2-mm focal spot range and maximum tube voltage of 150 kVp in fluorography and 120 kVp in fluoroscopy. Cineradiographic sequences were acquired for…

Impiego degli ecoamplificatori di II generazione nei pazienti con trauma splenico

EFFECTS OF THE STATIC MAGNETIC FIELD GENERATED BY 0.5 T MRI UNIT ON TNF-alpha RELEASE OF HUMAN PBMC FROM PATIENTS WITH RHEUMATOID ARTHRITIS.

Transcranial magnetic resonance-guided focused ultrasound surgery at 1.5T: a technical note.

Magnetic resonance-guided focused ultrasound is one of the emerging non-invasive technologies offering both image guidance and thermal monitoring. In recent years transcranial application of this technology is starting to impact heavily the neuroscience field. We present here the imaging protocol and the technological methods successfully used with a transcranial magnetic resonance-guided focused ultrasound system certified for clinical treatments of functional neurological disorders, integrated for the first time with a 1.5T magnetic resonance scanner. Compared to the body radiofrequency coil (the one commonly used with transcranial magnetic resonance-guided focused ultrasound system integ…

Comparison between whole-body MRI with diffusion-weighted imaging and PET/CT in staging newly diagnosed FDG-avid lymphomas.

Abstract Objectives To compare whole body-MRI (WB-MRI) with diffusion-weighted imaging and FDG-PET/CT in staging newly diagnosed FDG-avid lymphomas. Methods 68 patients (37 males, 31 females; median age 42 years; range 15–86 years) with histologically confirmed lymphoma (37 Classical Hodgkin, 16 Diffuse large B-cell, 10 Follicular, 5 Mantle cell) underwent both MRI and FDG-PET/CT before treatment. Ann Arbor stages obtained with WB-MRI and FDG-PET/CT were compared using Cohen’s k statistics. Moreover WB-MRI and FDG-PET/CT stages were compared with the pathological stages obtained after the diagnostic iter using also bone marrow and available biopsies if clinically indicated. Results The agre…

Myocardial bridging and related coronary atherosclerotic burden by 64-slice CT coronary angiography

postmortem MDCT in the evaluation of air crash victims

Ruolo dell'esame RM dell'encefalo nella gestione di pazienti affetti da talassodrepanocitosi in trattamento con idrossiurea

Role of cardiac computed tomography in the evaluation of coronary artery stenosis in patients with ascending aorta aneurysm detected at transthoracic echocardiography

OBJECTIVE The aim of our study was to evaluate the diagnostic performance of cardiac computed tomography (CCT) in the evaluation of coronary artery stenosis in patients with ascending aorta aneurysm detected at transthoracic echocardiography. METHODS We conducted a retrospective analysis of patients with an aneurysm 45 mm or greater at transthoracic echocardiography who underwent CCT from 2012 to 2014 in our hospital. We calculated the sensitivity, specificity, and positive and negative predictive values of CCT for the assessment of coronary artery stenosis (<50% or ≥50% stenosis) in patients who underwent conventional coronary angiography. RESULTS We included 104 patients (73 men, aged 64 …

Diagnostic performance of qualitative and radiomics approach to parotid gland tumors: which is the added benefit of texture analysis?

Objective: To investigate whether MRI-based texture analysis improves diagnostic performance for the diagnosis of parotid gland tumors compared to conventional radiological approach. Methods: Patients with parotid gland tumors who underwent salivary glands MRI between 2008 and 2019 were retrospectively selected. MRI analysis included a qualitative assessment by two radiologists (one of which subspecialized on head and neck imaging), and texture analysis on various sequences. Diagnostic performances including sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of qualitative features, radiologists’ diagnosis, and radiomic models were evaluated. Result…

Brain damage in hanging: A new CT finding

We report a 23-year-old man who attempted suicide by hanging. There have been few reports of involvement of the brain parenchyma shown on CT, all showing ischaemic lesions. This is the first report of multifocal intracerebral haematomas due to hanging seen on CT.

Hippocampal and Amygdalar Volumes Changes in Drug Addicts: A Preliminary Study

Oral comunication for American Society of Neuroradiology 45th Annual Meeting. Chicago, June 9-14 2007

Anomalous impregnation of the hepatic parenchyma after introduction of ecografic contrast medium

SCROTO ACUTO: DIAGNOSI DIFFERENZIALE DI UN'EMERGENZA MEDICO-CHIRURGICA NELL'IMAGING ECOGRAFICO

nd

Development of an OpenSource eLearning Radiology System

Fast Spin Echo e Spin-Echo

Uno dei maggiori problemi connessi alio studio del SNC di pazienti in età pediatrica con RM è indubbiamente costituito dalla durata dell'esame stesso, che impone sovente la necessità di una sedazione farmacologica del paziente e limita allo stretto indispensabile il numero delle acquisizioni effettuate. Appare pertanto facilmente intuibile l'entusiasmo rivolto verso nuovi tipi di sequenze che presentino quale caratteristica principale una drastica riduzione dei tempi di acquisizione pur mantenendo un'affidabile qualità diagnostica. Le sequenze di tipo Fast-Spin-Echo (FSE) costituiscono il successivo sviluppo delle sequenze denominate RARE (Rapid Acquisition Relaxation Enhanced) descritte d…

Focal nodular hyperplasias in normal and fatty liver: a quantitative evaluation with SH U 508A and pulse inversion ultrasound

MR imaging of the brain: findings in asymptomatic patients with thalassemia intermedia and sickle cell-thalassemia disease.

The purpose of this study was to evaluate the spectrum of MR findings of the brain in asymptomatic patients affected with thalassemia intermedia or sickle cell-thalassemia disease to prevent brain damage by identifying patients at risk for stroke so that transfusional or pharmacologic treatment could be implemented.Forty-one asymptomatic patients who were younger than 50 years and were affected by minor hemoglobinopathies underwent MR imaging of the brain. Ischemic lesions were classified as small, medium, or large and as single or multifocal. Atrophic changes were graded subjectively as mild, moderate, or severe. A grade of brain damage was assigned to every patient. The frequency and seve…

Broncoscopia virtuale in pazienti con lesioni endobronchiali stenosanti: ottimizzazione della tecnica con TC spirale monostrato

Imaging appearance of treated hepatocellular carcinoma

Surgical resection and imaging guided treatments play a crucial role in the management of hepatocellular carcinoma (HCC). Although the primary end point of treatment of HCC is survival, radiological response could be a surrogate end point of survival, and has a key role in HCC decision-making process. However, radiological assessment of HCC treatment efficacy is often controversial. There are few doubts on the evaluation of surgical resection; in fact, all known tumor sites should be removed. However, an unenhancing partial linear peripheral halo, in most cases, surrounding a fluid collection reducing in size during follow-up is demonstrated in successfully resected tumor with bipolar radio…

Evaluation of post-treatment response of epatocellular carcinoma: comparison of ultrasonography with second generation ultrasound contrast agent and dynamic CT.

Static magnetic fields generated by a 0.5T MRI unit affects in vitro expression of activation markers and interleukin release in human peripheral blood mononuclear cells (PBMC)

To investigate the effects of the static magnetic field (SMF) generated by a 0.5 T superconducting MRI unit on in vitro activation marker expression and interleukin release in human peripheral blood mononuclear cell (PBMC) samples from healthy volunteers.PBMC samples were split into two groups: exposed and sham-exposed under isothermal conditions. PBMC were exposed for 2 h at 24 degrees C to the SMF of a 0.5 T superconducting MRI unit. Immediately after exposure, both samples were cultured for 24 h at 37 degrees C with or without mitogenic stimulation by phytohaemagglutinin (PHA). PBMC were examined for expression of CD25, CD69 and CD71 by immunofluorescence analysis and supernatants were a…

Incidence of new foci of hepatocellular carcinoma after radiofrequency ablation: role of multidetector CT

Purpose. The authors sought to assess the incidence of new foci of hepatocellular carcinoma (HCC) using multidetector computed tomography (MDCT) in patients treated with radiofrequency ablation (RFA). Materials and methods. Two readers retrospectively reviewed by consensus the follow-up MDCT studies of 125 patients (88 men and 37 women; mean age 68 years) with 141 HCCs (size 1–5.2 cm; mean 2.2 cm) treated with RFA. MDCT follow-up was performed at 1 and 3 months and every 6–12 months thereafter. Reviewers assessed: (1) the presence of new HCC foci in the same liver segment or in a different segment; (2) complete or incomplete tumor ablation; (3) tumour progression. Results. A total of 113 ne…

0263: Percutaneous US-Guided Hematoma Aspiration to Reduce Recovery Time of II Grade Muscle Strain in Elite Soccer Players

Magnetic resonance imaging of the pituitary gland in patients with secondary hypogonadism due to transfusional hemochromatosis

To identify pituitary iron overload in patients with transfusional hemochromatosis causing secondary hypogonadism, we prospectively evaluated signal intensity abnormalities of the anterior lobe of the pituitary gland of 18 patients affected by transfusion-dependent thalassemia major and secondary hypogonadism. Magnetic resonance (MR) imaging is useful to assess pituitary iron overload in patients with transfusional hemochromatosis and secondary hypogonadism by detection of a significant decreased signal intensity of the anterior lobe of the pituitary gland on GRE T2*-weighted images. The decreased signal intensity of the anterior lobe of the pituitary gland on GRE T2*-weighted images was co…

Ultrasonic evaluation with second harmonic imaging and SonoVue in the assessment of cerebral perfusion in diabetic patients: a case-control study

The purpose was to compare human brain tissue perfusion in diabetic patients and healthy subjects with second harmonic imaging ultrasound and SonoVue to test the hypothesis that brain tissue perfusion differences are present in these two groups of patients. In a prospective case-control study, second harmonic examinations performed in 20 patients with type II diabetes mellitus and in 20 matched control patients were compared. After administration of 2.5 ml of SonoVue, 60 time-triggered images were recorded. Time-intensity curves, including peak intensity and positive gradient normalized to the middle cerebral artery, were calculated to quantify ultrasound intensity in a region of interest. …

Budd-Chiari Syndrome: Spectrum of Imaging Findings

OBJECTIVE: The objective of our study was to illustrate the imaging findings of Budd-Chiari syndrome, including CT, MRI, sonographic, and angiographic findings. CONCLUSION: The key imaging findings in Budd-Chiari syndrome are occlusion of the hepatic veins, inferior vena cava, or both; caudate lobe enlargement; inhomogeneous liver enhancement; and the presence of intrahepatic collateral vessels and hypervascular nodules. Awareness of these findings is important for early diagnosis and appropriate treatment.

Myocardial bridging and related coronary atherosclerotic burden by 64-slice CT coronary angiography

Gozzo semplice e nodulare

RUOLO DELLA TC CON MEZZO DI CONTRASTO NELLA DIAGNOSI DELLE COMPLICANZE DELLA PANCREATITE ACUTA NECROTIZZANTE

Whole-body MRI radiomics model to predict relapsed/refractory Hodgkin Lymphoma: A preliminary study.

Purpose A strong prognostic score that enables a stratification of newly diagnosed Hodgkin Lymphoma (HL) to identify patients at high risk of refractory/relapsed disease is still needed. Our aim was to investigate the potential value of a radiomics analysis pipeline from whole-body MRI (WB-MRI) exams for clinical outcome prediction in patients with Hodgkin Lymphoma (HL). Materials and methods Index lesions from baseline WB-MRIs of 40 patients (22 females; mean age 31.7 ± 11.4 years) with newly diagnosed HL treated by ABVD chemotherapy regimen were manually segmented on T1-weighted, STIR, and DWI images for texture analysis feature extraction. A machine learning approach based on the Extra T…

Thyroid nodules: prevalence, gray-scale and color-doppler pattern in a random adult population screened by high resolution US.

Evolution of indeterminate hepatocellular nodules at Gd-EOB-DPTA-enhanced MRI in cirrhotic patients

To retrospectively analyze the evolution of indeterminate hepatocellular nodules in cirrhotic patients on serial Gd-EOB-DPTA-enhanced MRI, and to identify predictors of HCC development. This IRB approved study included 33 cirrhotic patients with 69 indeterminate hepatocellular nodules (mean diameter 1.1 cm) at baseline Gd-EOB-DPTA-enhanced MRI and a Gd-EOB-DPTA-enhanced-MRI follow-up of at least 2 years. Two radiologists evaluated size and signal intensity of each nodule at baseline and follow-up. Age, cirrhosis etiology, and HCC history were recorded. Data were compared between nodules that became HCCs at follow-up (HCC) and those that did not (no-HCC). On follow-up, 5/69 nodules became HC…

Aspetti con TC ed RM delle cisti peribiliari

L’aterosclerosi nel tronco comune: relazione tra dimensioni e placche valutata mediante angiografia coronarica con TC a 64 strati

Pigmented villonodular synovitis of the foot: MR findings.

PURPOSE: To evaluate the MRI findings in the various forms of pigmented villonodular synovitis (PVNS) of the foot. MATERIALS AND METHODS: Seven hundred and fifty-three MR studies of the foot performed at our institute between June 1994 and April 2000 were retrospectively reviewed for the presence of PVNS. Spin echo (SE) T1W, Gradient echo (GE) T2*W, and fat suppression (Short Time Inversion Recovery: STIR) images were acquired with a 0.5 T superconductive unit (Vectra, GE Medical System, Milwaukee, WI, USA) provided with a dedicated transmitter/receiver coil. The site and type of lesions, the signal intensity patterns, and the presence of associated changes were evaluated. RESULTS: On the b…

Sialodochoplasty in the treatment of salivary-duct stricture in chronic sialoadenitis: technique and results

PURPOSE: This study was undertaken to investigate peroral balloon angioplasty of salivary-duct strictures (sialodochoplasty) in chronic sialadenitis, analysing the technique, results and limitations. MATERIALS AND METHODS: Nine patients underwent sialodochoplasty: seven for Stensen''s-duct strictures and two for Wharton''s-duct strictures. One patient had a double stricture of Stensen''s duct and another a salivary stone associated with a Wharton''s-duct stricture. All patients were subjected to preliminary sialography to evaluate stricture site, length and grade. Sialodochoplasty was performed after local anaesthesia and progressive dilation of the salivary-duct orifice. RESULTS: The stric…

Left kidney mass in a 45 year old woman

Performance diagnostica della TCMD a 64 strati ECG-GATED vs. GATED-SPECT in pazienti a rischio di malattia coronarica intermedio-alto con dolore toracico atipico

High-frequency ultrasound in the study of male breast palpable masses

Purpose. To evaluate the role of high frequency colour- Doppler ultrasound in the study of diffuse or local breast nodules in males, and compare these results with those of mammography. Materials and methods. We studied 105 men aged between 12 and 82 years (mean age 42.3 years) with a palpable breast mass with or without pain. All patients underwent clinical and ultrasound examination. Seventyeight also underwent mammography, whereas 27 did not because of young age (under 25 years) (n=10), no clinical or sonographic suspicion of a malignant mass (n=16), and ulcerated neoplastic lesion (n=1). The final diagnosis derived from surgery in six patients and from three-year follow-up for 99 patien…

Cavernous hemangioma associated with other hepatic masses at CT and MRI

MRI of inner ear fluids using modified GRASS sequences: a useful tool in the assessment of the normal and pathological labyrinth

MRI is acquiring a progressively more important role in the investigation of petrous bone disease. Nevertheless, despite the extensive use of MRI in the detection of inflammatory or neoplastic involvement of the seventh and eighth cranial nerves, conventional spinecho images cannot be considered the modality of choice in inner ear imaging “Steady-state sequences” are known to be motion sensitive. By setting a very short repetition time, a large flip angle and a long echo time, one can obtain a sequence sufficiently sensitive to the slow movement of endo- and perilymph. We report our experience in MRI of normal and pathological inner ear with modified GRASS sequences.

Focal lesions of the Achilles tendon: real-time variation of lesion grading during ultrasound-guided platelet-concentrate injection.

INTRODUCTION: Achillodynia (Achilles tendon pain) is a significant source of disability for many sport people. Achilles tendon (AT) tear is the third most frequent major tendon disruption after those of the rotator cuff and knee extensor mechanism. The incidence of the AT tears is 11–18% overall. Unlike acute AT tear, chronic tear diagnosis is more difficult to make particularly when the chronic tear involves the AT only partially. Over the last 10 years, real time ultrasound has been used increasingly to diagnose Achilles tendon tears, thanks to its ability to perform dynamic study, in passive and active muscle contraction. Furthermore, ultrasound-guided procedures are increasingly used fo…

role of the high resolution ultrasonography to andress the tratment of idiopatic plantar fascitisi with mini - invasive techniques

Usefulness of SonoVue-enhanced Pulse-Inversion Ultrasonography to Assess Hepatocellular Carcinoma Response after Percutaneous Radiofrequency Thermal Ablation Therapy

How to address the treatment of idiopathic plantar fasciitis with mini-invasive techniques: HRUS criterion

A new intraoral device to home assist Parkinson’s disease patients by distant control

[Detection of extra-articular soft-tissue involvement in rheumatoid arthritis: value of color-coded Doppler sonography]

Working in the mirror: The safety and effectiveness of closure access leading venous advanced gain new ability in a patient with dextrocardia

The evolution of devices in serious cardiac rhythm pathology management and in other medicine areas and its optimal management have progressively become a worldwide serious challenge. We present an upgrading to dual chamber im-plantable cardioverter-defibrillator (ICD) without complications in a 68 year old woman through closure access leading venous advanced gain new ability, complementing the mechanical multiple venous entry-site approach extraction. This is another of the few cases present in literature about ICD in patients with dextrocardia and it focuses on the safety and effectiveness of our simple technique also in a patient with dextrocardia.

Role of apparent diffusion coefficient values in prostate diseases characterization on diffusion-weighted magnetic resonance imaging.

BACKGROUND: To evaluate if normal and pathological prostate tissue can be distinguished by using apparent diffusion coefficient (ADC) values on magnetic resonance imaging (MRI) and to understand if it is possible to differentiate among pathological prostate tissues using ADC values.METHODS:Our population consisted in 81 patients (mean age 65.4 years) in which 84 suspicious areas were identified. Regions of interest were placed over suspicious areas, detected on MRI, and over areas with normal appearance, and ADC values were recorded. Statistical differences between ADC values of suspicious and normal areas were evaluated. Histopathological diagnosis, obtained from targeted biopsy using MRI-…

Preliminary experience with a transcranial magnetic resonance-guided focused ultrasound surgery system integrated with a 1.5-T MRI unit in a series of patients with essential tremor and Parkinson's disease.

OBJECTIVETranscranial magnetic resonance–guided focused ultrasound surgery (tcMRgFUS) is one of the emerging noninvasive technologies for the treatment of neurological disorders such as essential tremor (ET), idiopathic asymmetrical tremor-dominant Parkinson’s disease (PD), and neuropathic pain. In this clinical series the authors present the preliminary results achieved with the world’s first tcMRgFUS system integrated with a 1.5-T MRI unit.METHODSThe authors describe the results of tcMRgFUS in a sample of patients with ET and with PD who underwent the procedure during the period from January 2015 to September 2017. A monolateral ventralis intermedius nucleus (VIM) thalamic ablation was pe…

Infarct characterization using CT

Myocardial infarction (MI) is a major cause of death and disability worldwide. The incidence is not expected to diminish, despite better prevention, diagnosis and treatment, because of the ageing population in industrialized countries and unhealthy lifestyles in developing countries. Nowadays it is highly requested an imaging tool able to evaluate MI and viability. Technology improvements determined an expansion of clinical indications from coronary plaque evaluation to functional applications (perfusion, ischemia and viability after MI) integrating additional phases and information in the mainstream examination. Cardiac computed tomography (CCT) and cardiac MR (CMR) employ different contra…

Contrast-enhanced ultrasonography in the characterization of benign focal hepatic lesions: spectrum of findings

MR imaging of pancreatic changes in patients with transfusion-dependent beta-thalassemia major.

The aim of this study was to evaluate MR imaging changes of the pancreas in patients with transfusion-dependent beta-thalassemia major.Twenty patients with transfusion-dependent beta-thalassemia major were examined using MR imaging at 0.5 T, with spin-echo T1-weighted, fast spin-echo T2-weighted, and gradient-echo T2*-weighted sequences. Image analysis was performed to assess pancreas-to-fat signal intensity ratios for all pulse sequences. Pancreatic exocrine and endocrine function and serum ferritin levels were assessed. Twenty healthy volunteers underwent MR imaging with the same three sequences and served as a control group.The pancreas-to-fat signal intensity ratio was significantly dec…

Stent Imaging: A Road Map To Overcome All The Factors Interferring With A Good Image Quality

Plain film, CT and MRI sensibility in the evaluation of intraorbital foreign bodies in an in vitro model of the orbit and in pig eyes.

Detection and characterization of intraorbital foreign bodies (IFB) is fundamental in acute trauma setting, preventing inflammatory sequelae or complications related to IFB movements when a MRI study is planned. Papers concerning plain film and CT sensibility in IFB detection show controversial results. For this reason we investigated plain film, CT and MRI sensibility in the evaluation of IFB. For an in vitro model, specimens of dry and fresh wood, glass, iron, plastic and graphite were immersed in animal lard and in a 0.9 % sodium chloride plus 3.5 g/dl human serum albumin solution. Specimens of different size and nature where also implanted into enucleated pig eyes. Air bubbles were intr…

EFFECTS OF ELECTROMAGNETIC FIELDS ON IFN-GAMMA RELEASE AND CONTENENT FROM HUMAN SUBSETS OF CD4+T CELLS.

Ruolo dell’ecografia con mezzo di contrasto nella caratterizzazione delle lesioni focali epatiche riscontrate incidentalmente

Characterization of hypoechoic focal hepatic lesions in patients with fatty liver: diagnostic performance and confidence of contrast-enhanced ultrasound

The objective of this study was to assess the diagnostic performance of contrast-enhanced ultrasound (CEUS) to characterize hypoechoic focal hepatic lesions (HFHL) in fatty liver (FL). A study group of 105 patients with FL and 105 HFHLs (52 malignant and 53 benign) underwent CEUS after SonoVue administration. Two blinded readers independently reviewed baseline ultrasound (US) and CEUS scans and classified each lesion as malignant or benign on a five-point scale of confidence, and recorded whether further imaging work-up was needed. Sensitivity, specificity, areas under the receiver operating characteristic (ROC) curve (A (z)), and interobserver agreement were calculated. We observed that th…

23. Resting state functional magnetic resonance imaging analysis of the brain of pathological gamblers

Purpose Gambling disorder has been recently reclassified under the category “substance-related and addictive disorders”. Recent studies performed through functional MRI (fMRI) have shown that the perseverance of some behaviors can alter brain activation [1] , [2] . In this work we aim at investigating functional connectivity changes in pathological gamblers (PGs) in comparison to healthy controls (HCs) by means of resting state functional Magnetic Resonance Imaging (rs-fMRI). Methods and materials Thirteen HCs and fourteen PGs were recruited (all right handed males; drugs free; mean age 36 ± 10 yrs). All acquisitions were performed through a 1,5 T MRI scanner using a 8-channels phased-array…

Hepatocellular carcinoma enhancement on contrast-enhanced CT and MR imaging: response assessment after treatment with sorafenib: preliminary results

PURPOSE: This study was undertaken to compare response evaluation criteria in solid tumours (RECIST) 1.1 and modified RECIST (mRECIST) in patients with unresectable hepatocellular carcinoma (HCC) on sorafenib, and to describe HCC enhancement changes before and after sorafenib treatment. METHODS AND MATERIALS: Seventeen patients (12 men, 5 women; mean age 69 years; age range 58-79 years) were included. Tumour response was assessed according to RECIST and mRECIST. Two readers placed a region of interest (ROI) within each target lesion, on the portion showing enhancement during the arterial phase. The lesion attenuation values measured within the ROIs on computed tomography or the signal inten…

Characterization of benign hepatic tumors arising in fatty liver with SonoVue and pulse inversion US.

Background: We describe the spectrum of contrast-enhancement patterns of benign hepatic tumors arising in fatty liver on contrast-enhanced ultrasound (US). Methods: Sixteen patients (12 women and four men) with 27 benign hepatic tumors (17 hemangiomas, eight focal nodular hyperplasias, and two hepatocellular adenomas) arising in fatty liver underwent baseline and pulse inversion US after administration of SonoVue. Two experienced radiologists evaluated baseline echogenicity and dynamic enhancement pattern of each lesion in comparison with adjacent liver parenchyma. Results: After administration of SonoVue, in the arterial phase 13 of 17 hemangiomas showed peripheral globular enhancement and…

3D versus 2D contrast-enhanced sonography in the evaluation of therapeutic response of hepatocellular carcinoma after locoregional therapies: preliminary findings

Objective: To investigate diagnostic performance of 3D contrast-enhanced ultrasound (CEUS) compared with 2D CEUS in the assessment of therapeutic response of hepatocellular carcinoma (HCC) treated with locoregional therapies (LRT). Materials and methods: Twenty-three consecutive patients (13 men and 10 women; mean age 65.5 years) with 23 HCCs (size range 1.2–7.2 cm; mean size 2.9 ± 1.4 cm) treated by means of radiofrequency ablation (RFA n = 9), transarterial chemoembolization (TACE n = 8), combined RFA and TACE (n = 3), percutaneous alcoholization (n = 2), and wedge resection (n = 1) underwent 2D and 3D CEUS 1 month (30 ± 2 days) after treatment. Magnetic resonance (n = 17) and computed to…

High Iodine Concentration Contrast Material for Noninvasive Multislice Computed Tomography Coronary Angiography

OBJECTIVE: The objective of this study was to compare intracoronary attenuation on 16-row multislice computed tomography (16-MSCT) coronary angiography using 2 contrast materials (CM) with high iodine concentration. MATERIAL AND METHODS: Forty consecutive patients (29 male, 11 female; mean age, 61 ± 11 years) with suspected coronary artery disease were randomized to 2 groups to receive 100 mL of either iopromide 370 (group 1: Ultravist 370, 370 mg iodine/mL; Schering AG, Berlin, Germany) or iomeprol 400 (group 2: Iomeron 400, 400 mg iodine/mL; Bracco Imaging SpA, Milan, Italy). Both CM were administered at a rate of 4 mL/s. All patients underwent 16-MSCT coronary angiography (Sensation 16; …

Spring ligament chronic injury on MR imaging

Sequential boost in neoadjuvant irradiation for T3N0-1 rectal cancer: long-term results from a single-center experience.

Purpose To evaluate the influence of radiation dose on tumor regression grade (TRG) and sphincter preservation rate in a series of cT3N0-1 rectal cancer patients treated with neoadjuvant chemoradiotherapy (CT-RT) with or without a sequential radiation boost. Materials and methods Between May 2002 and September 2013, 116 cases were eligible for retrospective evaluation. Radiotherapy was delivered for a total dose of 45 Gy (no boost arm) or 50.4 Gy (boost arm). TRG was evaluated with the Dworak scale. Results Median follow-up was 62 months (range, 12-138 months). The 5-year overall survival and local control rates were 72% and 93%, respectively. Fifty-five patients (47%) were treated with a s…

Radiomics Analysis on Gadoxetate Disodium-Enhanced MRI Predicts Response to Transarterial Embolization in Patients with HCC

Objectives: To explore the potential of radiomics on gadoxetate disodium-enhanced MRI for predicting hepatocellular carcinoma (HCC) response after transarterial embolization (TAE). Methods: This retrospective study included cirrhotic patients treated with TAE for unifocal HCC naïve to treatments. Each patient underwent gadoxetate disodium-enhanced MRI. Radiomics analysis was performed by segmenting the lesions on portal venous (PVP), 3-min transitional, and 20-min hepatobiliary (HBP) phases. Clinical data, laboratory variables, and qualitative features based on LI-RADSv2018 were assessed. Reference standard was based on mRECIST response criteria. Two different radiomics models were construc…

Utility of post mortem computed tomography in clivus fracture diagnosis. Case illustration and literature review

Clivus fractures are usually associated with head blunt trauma due to traffic accident and falls. A 23 - year-old man died immediately after a smash-up while he was stopping on his motorcycle. Post-mortem Computed tomography (PMCT), performed before autopsy, revealed a complex basilar skull base fractures associated with brainstem and cranio-vertebral junction injuries, improving the diagnostic performance of conventional autopsy. Imaging data were re-assessable and PMCT offers the possibility to perform multiplanar and volume rendered reconstructions, increasing forensic medicine knowledge related to traumatic injuries.

Ultrastructural biologic effects of sonography with pulse inversion and microbubble contrast in rabbit liver

Purpose This prospective study was conducted to evaluate the biologic effects of microbubble destruction with pulse-inversion harmonic imaging on rabbit liver parenchyma. Methods The livers of 6 albino rabbits were examined sonographically by a single investigator. Three rabbits underwent contrast-enhanced sonography, with scanning starting 5 seconds after injection by using pulse-inversion harmonic imaging with a mechanical index of 1.2. Four time-triggered images were recorded at a rate of 1 frame every 2 seconds. For comparison, 3 control rabbits had pulse-inversion harmonic imaging with a mechanical index of 1.2 only, without contrast medium. Immediately after sonography, the animals we…

Anomalie coronariche mediante angiografia coronarica con TC a 64 strati e relativo quadro angiografico convenzionale

Radiologic team performance index: A new paradigm in KPI evaluating radiology examination volumes department performance: Results of Sicilian regional healthcare system survey

Background: Efficient management of Radiologic Operative Units (ROU) because population health needs increase while healthcare systems provide less resources expendable in technologies and employee. Purpose: Create a Key Performance Indicator (KPI) defined Radiologic Team Performance Index (RTPI) able to compare the activity and efficiency of ROU operating under different environments and with different resources. Methodology/Approach: A survey was conducted in Sicilian Public Healthcare System on behalf of Sicilian Group of Italian Society of Medical Radiology (SIRM) for a total of 63 investigated ROU. Obtained informations concern workforce, emergency care organization, technologies avail…

Arterially enhancing liver lesions: significance of sustained enhancement on hepatic venous and delayed phase with magnetic resonance imaging.

Benign hepatic vascular neoplasms and vascular pseudolesions are commonly encountered in magnetic resonance (MR) imaging. Most of these benign lesions demonstrate not only arterial-phase hyperintensity, but also persistent enhancement on venous and delayed imaging, unlike most malignant hepatic masses. These features, along with other MR findings and morphological characteristics, may allow for more confident diagnosis and distinction from hepatic malignancy. The objective of our study was to illustrate the MR imaging findings of hepatic lesions that demonstrate both early arterial and sustained enhancement on hepatic venous and delayed phase.

Presacral Myelolipoma

Many reports have described adrenal myelolipomas but there have been only a few reports of extra-adrenal myelolipomas. We describe a 74-year-old woman who came to our observation for MRI of the lumbar spine for typical lumbar back pain. In addition to signs of mild scoliosis and spondylo disc arthrosis, MR imaging revealed a presacral mass showing a heterogeneously high signal in all pulse sequences and almost completely suppressed on inversion recovery sequences for fat tissue. CT imaging confirmed the fatty nature of the lesion and no signs of bone involvement. These findings were most consistent with a diagnosis of a rare presacral myelolipoma as confirmed at histopathologic analysis. T…

Diffusion tensor imaging in amyotrphic lateral sclerosis: quantitative assesment ot the corticospinal tract degeneration.

Poster for European Society of NeuroRadiology. Genoa, 20-23 September 2007

Biological effects from ultrasounds with pulse inversion and contrast medium on the rabbit liver

Comparison of 1.0 M gadobutrol and 0.5 M gadopentate dimeglumine-enhanced MRI in 471 patients with known or suspected renal lesions : results of a multicenter, single-blind, interindividual, randomized clinical phase III trial

The purpose of this phase III clinical trial was to compare two different extracellular contrast agents, 1.0 M gadobutrol and 0.5 M gadopentate dimeglumine, for magnetic resonance imaging (MRI) in patients with known or suspected focal renal lesions. Using a multicenter, single-blind, interindividual, randomized study design, both contrast agents were compared in a total of 471 patients regarding their diagnostic accuracy, sensitivity, and specificity to correctly classify focal lesions of the kidney. To test for noninferiority the diagnostic accuracy rates for both contrast agents were compared with CT results based on a blinded reading. The average diagnostic accuracy across the three bli…

PANCREATIC CARCINOMA VERSUS CHRONIC FOCAL PANCREATITIS: CONTRAST-ENHANCED POWER DOPPLER ULTRASONOGRAPHY FINDINGS

Background: We assessed the potential usefulness of contrast-enhanced power Doppler ultrasonography (US) for differentiating pancreatic carcinoma from chronic focal pancreatitis. Methods: Twenty-six consecutive patients with ductal carcinoma (n=16) and chronic focal pancreatitis (n=10) underwent power Doppler US examinations before and after intravenous injection of an air-based contrast agent (Levovist, Schering, Berlin, Germany). Final diagnosis was obtained by surgery in all patients. The following parameters before and after intravenous administration of contrast agent were evaluated for each lesion: number, morphology and course of the vessels within the lesion and time to maximum dete…

Budd-Chiari Syndrome: spectrum of imaging findings.

La Cardio-TC nel paziente diabetico: approccio clinico e aspetti dell'imaging

TCMD-64 strati ECG-GATED nella valutazione della funzione globale del ventricolo sinistro: quanto tempo è necessario e quanto sono attendibili i valori ottenuti?

Usefulness of SonoVue-enhanced Pulse-Inversion Ultrasonography to Assess Hepatocellular Carcinoma Response after Percutaneous Radiofrequency Thermal Ablation Therapy

BIOLOGICAL EFFECTS FROM ULTRASOUNDS WITH PULSE INVRSION AND CONTRAST MEDIUM ON THE RABBIT LIVER

Monitoring of fracture calluses with color Doppler sonography.

Purpose Fracture callus formation is closely associated with vascular invasion, and the use of color Doppler sonography has been suggested as a means to monitor, earlier than gray-scale sonography, the first stages of the healing process. We report the findings in a series of patients with tibial fractures in whom both gray-scale sonography and color Doppler imaging were employed to monitor new bone formation at the fracture site. Methods Twenty patients with tibial fractures treated with external fixator frames were examined sonographically about 10 days after surgery and then about every 25 days until radiographic demonstration of consolidation. Results Eighteen of 20 patients had a well-…

Caecal leiomyoma detected by whole-body MRI in a patient with Hodgkin lymphoma: first case report

Introduction. Hodgkin Lymphoma (HL) is one of the most curable malignant diseases. Modern treatments, like the combined radiochemotherapy and stem cell transplantation, have increased the number of malignant disease survivors. However, HL survivors are at risk of long-term effects, including the development of solid tumors. Secondary neoplasms are a major cause of late morbidity and mortality following treatment for HL. Case report. We report the case of a male patient, treated for HL by chemotherapy, who developed a large leiomyoma of the cecum one year after the treatment. A whole-body Magnetic Resonance (WBMRI) scan performed during the follow-up allowed the detection of this incidental …

A rare case of pedunculated bronchial hemangioma

We describe a rare case of pedunculated endobronchial hemangioma observed in a 60 years old patient complaining of chronic productive cough and accessional dyspnea which had been progressively worsening over 20 years. The lesion was first noticed at fiberoptic bronchoscopy; then computed tomography scan was performed and integrated with tridimensional reconstruction techniques. Pathology showed the picture of a vascular neoplasm, compatible with capillary hemangioma. The lesion was submitted to laser-assisted endoscopic removal in order to relieve the obstruction, leading to remission of symptoms.

Descrizione degli aspetti qualitativi e quantitativi della placca aterosclerotica coronarica mediante angiografia coronarica con TC a 64 strati

Imaging dell’ischemia mesenterica mediante TC Multistrato

Review the etiology and pathophysiology of mesenteric ischemia with an outline of the mesenteric circulation. Describe the TC protocol to be used for the study of mesenteric ischemia and the TC signs that characterize it.

Hepatocellular Carcinoma Presenting at Contrast-Enhanced Multi–Detector-Row Computed Tomography or Gadolinium-Enhanced Magnetic Resonance Imaging as a Small (≤2 cm), Indeterminate Nodule

OBJECTIVE: The objective of the study was to measure growth rate and to determine the optimal interval time for imaging follow-up of hepatocellular carcinomas (HCCs) presenting at multi-detector-row computed tomography (MDCT) or magnetic resonance imaging (MRI) as small, indeterminate lesions. METHODS: We included patients with cirrhosis with HCC initially presenting as indeterminate lesion of 2 cm or less at MDCT or MRI August 2005 to August 2009 and with available imaging follow-up. Measures of tumor growth included tumor volume doubling time (TVDT), tumor percentual diameter increase, and tumor percentual volume increase. RESULTS: We examined 48 patients (mean age, 64 years) with 69 HCCs…

Caratterizzazione delle lesioni focali epatiche ipoecogene in pazienti con fegato steatosico: “performance” e livello di confidenza diagnostica dell’ecografia con SonoVue®”

Forty-slice MDCT enteroclysis: evaluation after oral administration of isotonic solution in Crohn's disease.

Objective. The aim of this study was to evaluate the accuracy of multidetector computed tomography (MDCT) enteroclysis after oral hyperhydration with isotonic solution in detecting bowel wall alterations in patients with Crohn’s disease. Materials and methods. Twenty-eight patients with a diagnosis of Crohn’s disease established by ileocolonoscopy and histology were enrolled in the study; 15 patients with negative ileocolonoscopy served as controls. In all cases, MDCT enteroclysis was performed after oral administration of 2,000 ml of isotonic solution and intravenous administration of N-butylscopolamine. Axial, isotropic multiplanar and volume-rendered reconstructions were used to evaluate…

Imaging of urinary bladder hernias

Lorenzo E. Bacigalupo1, Michele Bertolotto2, Filippo Barbiera3, Pietro Pavlica4, Roberto Lagalla3, Roberto S. Pozzi Mucelli2, Lorenzo E. Derchi1 Bacigalupo LE, Bertolotte M, Barbiera F, et al. erniation of the urinary bladder is not rare. It is usually considered that 1–3% of all inguinal hernias involve the bladder [1], and Iason [2], in 1944, reported an incidence of 10% in men older than 50 years. Most bladder hernias involve the inguinal and femoral canals, with the latter more frequent in women, and a predilection for the right side has been reported. However, herniations through ischiorectal, obturator, and abdominal wall openings have also been described. Any portion of the bladder m…

40-slice computed tomography enteroclysis after oral hyperhydration with isotonic solution in comparison with ileocolonoscopy in patients with Crohn's disease

Imaging ecografico post-terapia ablativa

ASSESSMENT OF BRAIN METASTASES VOLUME CONTROL DURING STEREOTACTIC RADIOSURGERY BY LONGITUDINAL REGION GROWTH MR IMAGE SEGMENTATION ANALYSIS

Apparato genitale femminile e maschile.

Focal nodular hyperplasia: a weight-based, intraindividual comparison of gadobenate dimeglumine and gadoxetate disodium-enhanced MRI

PURPOSE: We aimed to qualitatively and quantitatively compare the enhancement pattern of focal nodular hyperplasia after gadobenate dimeglumine and gadoxetate disodium injection in the same patient. METHODS: 1.5 T magnetic resonance imaging (MRI) examinations of 16 patients with 21 focal nodular hyperplasias studied after the injection of both contrast media were evaluated. Both MRI studies were performed in all patients. A qualitative analysis was performed evaluating each lesion in all phases. For quantitative analysis we calculated signal intensity ratio, lesion-to-liver contrast ratio and liver parenchyma signal intensity gain on hepatobiliary phase. Statistical analysis was performed w…

Reversible MRI abnormalities in an unusual paediatric presentation of Wernicke's encephalopathy

Background. We report an unusual paediatric presentation of acute Wernicke's encephalopathy in a 12-year-old boy affected by chronic gastrointestinal disease. MRI demonstrated, in addition to the typical diencephalic and mesencephalic signal abnormalities on T2-weighted images, enhancement of the mammillary bodies and the floor of the hypothalamus. Materials and methods. Following parenteral administration of thiamine for 4 days, the patient recovered from his neurological deficits and on follow-up enhanced MRI 1 month later, no signal abnormalities were found nor was there diencephalic or mesencephalic atrophy, as is usual in the chronic phase of the disease. Results. MRI provides crucial …

ANOMALUS IMPREGNATION OF THE HEPATIC PARENCHYMA AFTER INTRODUCTION OF ECOGRAFIC CONTRAST MEDIUM

Ruolo dell’angiografia TC Multistrato cardiosincronizzata nella valutazione dell’aorta ascendente dopo chirurgia conservativa della valvola aortica.

Su di un caso di Schwannoma primitivo intraorbitario

Gli Schwannomi costituiscono il 6,8% dei tumori intracranici ed originano solitamente dai nervi sensitivi, con particolare predilezione per il V e VIII nervo cranico. Uno schwannoma a partenza da un nervo oculomotore costituisce invece una evenienza piuttosto rara, e solo 17 casi di s. del III n.c. sono stati documentati in letteratura. Sono da considerare ancora più rari gli schwannomi ad esclusiva localizzazione intraorbitaria (1–5, 7% dei tumori orbitari). Solitamente tipico dell'uomo adulto, con l'eccezione dei soggetti affetti da Neurofibromatosi di tipo 2, lo schwannoma orbitario esordisce solitamente come un processo espansivo a lento accrescimento, determinante diplopia, esoftalmo …

Imaging processing for CT angiography of the cervicocranial arteries: evaluation of reformatting technique.

Purpose. The aim of this study was to compare computed tomography angiography (CTA) sliding-thin-slab (STS) multiplanar reformatting (MPR), STS maximum intensity projection (MIP) and three-dimensional (3D) volume rendering (VR) reformatting techniques in the evaluation of cervicocranial arteries. Materials and methods. Twenty patients examined with multislice CT were included in this study. CTA images were reformatted as STS-MIP, STS-MPR and 3DVR in orthogonal planes and in the oblique-coronal plane. Images were evaluated in consensus by two radiologists, with a third radiologist to resolve discordances in grading image quality parameters. The Spearman correlation analysis was performed to …

Characterisation of focal liver lesions undetermined at grey-scale US: contrast-enhanced US versus 64-row MDCT and MRI with liver-specific contrast agent

The aim of this study was to assess the role of contrast-enhanced ultrasonography (CEUS) in the characterisation of focal liver lesions in comparison with multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) with liver-specific contrast agent.One hundred and eighty-seven focal liver lesions, 91 malignant and 96 benign (mean size 3.2 cm) - proved by biopsy (n=12), histology (n=4), MDCT (n=108), MRI (n=44) MDCT/MRI (n=19) - in 159 patients were studied by CEUS. Two expert radiologists consensually evaluated the contrast-enhancement patterns at CEUS. For each lesion, they assessed: (a) nature (benign, malignant, not assessable), (b) specific diagnosis and (c) need for …

Role of Color Doppler Ultrasonography to Address the treatment of Epicondylitis with Mini-Invasive Techniques.

MR imaging of perianal fistulas in Crohn's disease: Sensitivity and specificity of STIR sequences

Introduction Although some studies proved the role of STIR sequences in the evaluation of perianal fistulas in Crohn's Disease (CD), contrast medium is still injected in many institutions since there is not a validated reference MR protocol. Our purpose was to evaluate the role of the STIR sequence in the detection and characterization of perianal fistulae comparing it to the post-contrast T1 sequence and correlating it with rectal examination under anesthesia. Materials and methods We retrospectively reviewed all clinical records of 31 CD patients, suspected of having perianal fistulas, who had been submitted to an MR study before and after contrast medium injection and surgical exploratio…

Ruolo della Colangio-RM (1,5 T) nella valutazione delle complicanze post-chirurgiche in pazienti trattati con ERCP. Nostra esperienza

Accumulo di ferro a livello ipofisario in pazienti affetti da beta-talassemia major: Aspetti RM

Gli autori si propongono di valutare le modificazioni del segnale RM a livello ipofisario nella emosiderosi secondaria in pazienti affetti da beta-talassemia major. Lo studio è stato condotto prospetticamente su un gruppo di 20 pazienti in regime alto-trasfusionale e trattamento ferro-chelante e su 10 volontari sani come gruppo di controllo. Gli esami RM sono stati condotti con apparecchiatura a magnete superconduttivo a 0,5T con sequenze SE TI-dipendenti e GRE TE*-dipendenti. Il sovraccarico di ferro è stato valutato mediante il dosaggio della ferritina sierica. è stata effettuata una valutazione quantitativa delle immagini RM SE T1- e GRE T2*-dipendenti attraverso la misurazione, mediant…

Valore diagnostico dell’ipodensita’ miocardica riscontrata nell’AC-TCMS: confronto con altre tecniche strumentali

246. Analysis of signal-to-noise ratio for a 2-channels coil developed to enable transcranial Magnetic Resonance-guided Focused Ultrasound Surgery (tcMRgFUS) with 1.5 T MRI scanners

Abstract Purpose In recent years trans-cranial Magnetic Resonance-guided Focused Ultrasound Surgery (tcMRgFUS) treatments have aroused large scientific and medical interest [1] . Usually, tcMRgFUS systems are integrated with 3 T systems which allow the use of the body RF coil for both real time imaging and MR-thermometry. At University Hospital of Palermo there is the world-first installation of a tcMRgFUS system integrated with a 1.5 T scanner. Here we present the characterization in terms of signal-to-noise ratio (SNR) of a dedicated RF coils suitably developed (by InSightec) to enable tcMRgFUS treatments with 1.5 T MR units. Methods and materials The focused ultrasound equipment (ExAblat…

Hypogonadotrophic Pituitary Insufficiency in Transfusional Hemochromatosis Complicating Thalassemia Major: MR Imaging

To identify pituitary iron overload in patients with transfusion-dependent thalassemia major causing secondary hypogonadism, we prospectively evaluated signal intensity abnormalities of the anterior lobe of the pituitary gland of 30 patients comparing spin-echo, gradient-echo imaging and pituitary T2 relaxation times measurement. We found that pituitary iron overload can best be assessed by MR imaging using gradient-echo T2*-weighted technique to establish signal reduction in the anterior lobe of the pituitary gland. This finding is correlated to increasing serum ferritin level — a parameter that reflects the severity of iron overload, and is more evident in patients with secondary hypogon…

Artificial Intelligence Applications on Restaging [18F]FDG PET/CT in Metastatic Colorectal Cancer: A Preliminary Report of Morpho-Functional Radiomics Classification for Prediction of Disease Outcome

Featured Application Based on results defined in this study, new investigations might propose morpho-functional-based radiomics algorithms for risk stratification with possible impact on treatment management in colorectal cancer. The aim of this study was to investigate the application of [F-18]FDG PET/CT images-based textural features analysis to propose radiomics models able to early predict disease progression (PD) and survival outcome in metastatic colorectal cancer (MCC) patients after first adjuvant therapy. For this purpose, 52 MCC patients who underwent [F-18]FDGPET/CT during the disease restaging process after the first adjuvant therapy were analyzed. Follow-up data were recorded f…

La preparazione in angiografia coronarica mediante TC a 64 strati nelle donne: una “sfida” per il radiologo?

Focal nodular hyperplasia: typical and atypical MR imaging findings with emphasis on the use of contrast media

Contrast-enhanced versus baseline US in the Characterization of benign focal hepatic lesions.

Comparison of Single-Echo T2-weighted Fast Spin-Echo and Conventional Spin-Echo MR Sequences

We compared single-echo T2-weighted fast spin-echo (FSE) magnetic resonance imaging and conventional spin-echo (CSE) T2-weighted imaging in the detection of brain lesions of multiple sclerosis (MS). 16 patients with clinically definite MS underwent brain imaging at 0.5 T with T2-weighted single-echo fast spin-echo (FSE) and conventional spin-echo (CSE) sequences. Image analysis was performed by three of the investigators who worked together to reduce interobserver variability. Statistical analysis was performed using Student's t test to assess the difference in the contrast-to-noise (C/N) ratio of MS lesions between CSE and FSE sequences. The Wilcoxon signed rank test was used to evaluate …

Focal confluent fibrosis: findings at CT and MRI in the cirrhotic liver

Focal confluent fibrosis: findings at CT and MRI in the cirrhotic liver Nome del convegno: European Congress of Radiology-ECR 2004 Luogo del convegno: Vienna Dettaglio tipologia d'Ateneo: 9 - Abstract di Comunicazioni o Poster di Congressi internazionali pubblicati (anche on line)

Analisi sequenziale della frequenza cardiaca durante l’esecuzione di una Cardio-TC: quali fattori influenzano la sua variabilità?

Cerebral Vessels.

Computed tomography of bowel obstruction: Tricks of the trade

Bowel obstruction (BO) is a frequent cause of hospitalization and surgical consultation for acute abdominal pain. It is usually suspected at physical examination, but clinical and laboratory data are often nonspecific. Thus, computed tomography plays a crucial role in a correct diagnosis of BO. Indeed, computed tomography can confirm a diagnosis of BO, and identify the location and cause of the obstruction. In this review, the computed tomography appearances of common and uncommon causes of BO and pseudo-obstruction are reviewed.

Biologic effects of ultrasound on liver cells of rat embryos.

Experiments on the biologic effects of ultrasound (US) were carried out on rat embryos exposed for 120 s to a US beam showing features similar to those already employed for diagnostic purposes. Electron microscopic investigation of the liver parenchyma of rat embryos confirmed results obtained from adult guinea pigs with the same duration of exposure, i.e. diffuse vacuolization of cytoplasma and varying degrees of mitochondrial damage.

Color Doppler ultrasonography in pediatric intussusception.

CDU was used in 11 children with intussusception. Demonstration of vascular images within the "pseudokidney" mass was possible in none of 11 cases. Of them, eight could be treated by hydrostatic reduction. In the remaining case, marked edema of the bowel wall did not allow reduction, and surgery had to be performed: no necrosis was observed in the surgical specimen. Both patients in whom CDU failed to demonstrate vascular signals had necrosis at surgery, and bowel resection was performed. Because of the limited number of patients examined at this time, no firm conclusions can be drawn from our experience. However, CDU seems a promising technique in detecting vascular changes occurring in in…

Osteonecrosi individuate mediante RM whole body in pazienti con Linfoma di Hodgkin trattati mediante BEACOPP.

Scopo: Il trattamento del Linfoma di Hodgkin (LH) ha condotto al raggiungimento di elevati tassi di sopravvivenza [1]. Il protocollo ABVD (Doxorubicina, Bleomicina, Vinblastina e Dacarbazina) è stato considerato per molto tempo il regime chemioterapico standard nei pazienti con LH [2], grazie a una ben documentata efficacia e una scarsa tossicità. Molti studi hanno dimostrato la maggiore efficacia del protocollo BEACOPP (Bleomicina, Etoposide, Doxorubicina, Ciclofosfamide, Vincristina, Procarbazina, Prednisone) rispetto all'ABVD [3], al costo di una maggiore tossicità. L'osteonecrosi [ON] è una possibile complicanza della chemioterapia che può compromettere la qualità di vita del paziente, …

Postmortem Imaging in Mass Disasters

The term “mass casualty” in the forensic field refers to a sudden tragic event involving a large number of people; such an event determines the need to perform a large number of autopsy exams, possibly in a short time. Mass casualties tend to involve emergencies that are unexpected and result in stressful situation when even those with no or scarce interest or experience could be called to play a role. Radiology could be helpful in the task of identifying victims, in cooperation with a multidisciplinary team, usually headed by a forensic specialist.

Riempimento centrifugo (“inside-out”) degli angiomi epatici all’ecografia con mezzo di contrasto

An atypical clinical presentation of acute appendicitis in a young man with midgut malrotation

Abstract Midgut malrotation occurs as a result of failure in normal intestinal rotation and fixation during early pregnancy. Pathological conditions reported in the literature involving midgut malrotation predominantly relate to infants and children. In adults malrotation is often revealed as an incidental finding on computed tomography (CT), or the associated altered anatomy can be the cause of atypical clinical symptoms of relatively common intestinal disorders. An unusual presentation of acute appendicitis, with fever and recurrent pain in left iliac fossa is reported. Underlying intestinal malrotation delayed the correct clinical diagnosis of acute appendicitis. It was not until a CT sc…

Intraoperative imaging findings in transcranial MR imaging-guided focused ultrasound treatment at 1.5T may accurately detect typical lesional findings correlated with sonication parameters

To assess the intraoperative neuroimaging findings in patients treated with transcranial MR-guided focused ultrasound (tcMRgFUS) thalamotomy using 1.5T equipment in comparison with the 48-h follow-up.Fifty prospectively enrolled patients undergoing unilateral tcMRgFUS thalamotomy for either medication-refractory essential tremor (n = 39) or Parkinson tremor (n = 11) were included. Two radiologists evaluated the presence and size of concentric lesional zones (zone I, zone II, and zone III) on 2D T2-weighted sequences acquired intraoperatively after the last high-energy sonication and at 48 h. Sonication parameters including number of sonications, delivered energy, and treatment temperatures …

Thyroid nodules: prevalence, grey-scale, and color doppler pattern in a random adult population screened by high-resolution US

Orbital varices: a tricky diagnosis in MRI

Orbital varix (OV) is a rare condition causing intermittent positional exophthalmos. Because of low venous pressure, OVs tend to collapse, being frequently undetectable in routine CT or MRI examinations. We describe one case of giant intraorbital varix studied with CT and MRI techniques.

Coronary artery anomalies: incidence, pathophysiology, clinical relevance and role of diagnostic imaging

Conventional coronary angiography is the gold standard for the diagnosis of coronary artery anomalies. Coronary anomalies are relatively rare findings in patients undergoing conventional coronary angiography for suspected obstructive coronary artery disease. Recently, the increasing performance of diagnostic techniques, such as electron beam tomography (EBT), magnetic resonance (MR) and, more recently, multislice computed tomography (MSCT), has enabled their application to cardiac imaging. MSCT, in particular, has a prominent role in coronary imaging due to its spatial and temporal resolution and three-dimensional capabilities. We report the incidence and pathophysiology of coronary artery …

Pitfalls nelle RM whole body con sequenze DWIBS eseguite in pazienti con linfoma.

Obiettivi didattici: Illustrare i principali artefatti ed insidie nella valutazione della Risonanza Magnetica Whole Body (RM-WB) dopo revisione di 331 RM-WB eseguite in pazienti con linfoma. Introduzione: La RM-WB con imaging pesato in diffusione (DWI) è un esame che consente uno studio total body con elevata risoluzione di contrasto, evitando l’esposizione a radiazioni ionizzanti e la somministrazione di mezzo di contrasto [1]. Nel 2004 Takahara ha introdotto una sequenza DWI con tecniche di soppressione del segnale chiamata DWIBS [2]. Questa consente di acquisire rapidamente immagini di multiple aree del corpo sfruttando l’imaging parallelo SENSE che incrementa la risoluzione e riduce gli…

Focal lesions in cirrhotic liver: what else beyond hepatocellular carcinoma?

Detection and characterization of focal lesions in the cirrhotic liver may pose a diagnostic dilemma. Several benign and malignant lesions may be found in a cirrhotic liver along with hepatocellular carcinoma (HCC), and may exhibit typical or atypical imaging features. In this pictorial essay, we illustrate computed tomography and magnetic resonance imaging findings of lesions such as simple bile duct cysts, hemangioma, focal nodular hyperplasia-like nodules, peribiliary cysts, intrahepatic cholangiocarcinoma, lymphoma, and metastases, all of which occur in cirrhotic livers with varying prevalences. Pseudolesions, such as perfusion anomalies, focal confluent fibrosis, and segmental hyperpla…

Radiologia e malattia celiaca dell'adulto

Evidence-Based Knowledge Management: an approach to effectively promote good health-care decision-making in the Information Era.

The sharing of information and the growth of knowledge together represent a foundation for the promotion of quality improvement of health care systems. This paper concerns knowledge, not only from an epistemological point of view, but also from a pragmatic one. In our paper, knowledge is discussed as the hub to promote better decision making and continuous professional development. Effective thinking is particularly needed. The critical point is to think about how health care systems can develop both an effective knowledge management network and how health-care organizations can actually be based on it. In this way, knowledge and knowledge hierarchy are defined according to Russel Achkoff's…

Caratterizzazione delle neoplasie epatiche benigne: ecografia ad inversione impulso con mezzo di contrasto di I e II generazione a confronto

RENE A SPUGNA MIDOLLARE VS MALATTIA POLICISTICA RENALE DELL'ADULTO: DIAGNOSI DIFFERENZIALE RADIOLOGICA

Confronto tra RM Whole Body, TC/PET e biopsia osteomidollare, nella valutazione dell’interessamento midollare in 104 pazienti con linfoma.

Scopo: Parte della stadiazione dei linfomi prevede la valutazione dell'interessamento del midollo osseo (IMO) mediante biopsia osteo-midollare (BOM) [1]. Tuttavia, secondo le ultime linee guida, la BOM non è più indicata per lo studio dei linfomi di Hodgkin [2]. La TC/PET è la tecnica di imaging standard per la stadiazione dei linfomi FDG-avidi, mentre la TC è indicata nei pazienti con istotipi non FDG-avidi [1]. Molti studi hanno dimostrato affidabilità ed elevata accuratezza diagnostica della Risonanza Magnetica Whole Body (RM-WB) nella stadiazione dei linfomi [3,4]. Lo scopo del nostro studio è stato quello di confrontare RM-WB, TC/PET e BOM, nella valutazione dell’IMO in pazienti con li…

Ca-score nella valutazione del paziente a rischio intermedio di eventi cardiaci acuti: modificazioni del profilo di rischio

Valore dell’esame TC di perfusione nell’ischemia cereb

Fibropolycystic Liver Disease: CT and MR Imaging Findings

Fibropolycystic liver disease encompasses a spectrum of related lesions of the liver and biliary tract that are caused by abnormal embryologic development of the ductal plates. These lesions (congenital hepatic fibrosis, biliary hamartomas, autosomal dominant polycystic disease, Caroli disease, choledochal cysts) can be clinically silent or can cause signs and symptoms such as cholangitis, portal hypertension, gastrointestinal bleeding, infections, and space-occupying masses. The different types of fibropolycystic liver disease demonstrate characteristic findings at computed tomography (CT) and magnetic resonance (MR) imaging. Patients with congenital hepatic fibrosis typically have imaging…

Late gadolinium-enhanced magnetic resonance imaging in non-compacted ventricular myocardium (NCVM) as potential expression of the disease severity

Deep Learning Network for Segmentation of the Prostate Gland With Median Lobe Enlargement in T2-weighted MR Images: Comparison With Manual Segmentation Method

Purpose: Aim of this study was to evaluate a fully automated deep learning network named Efficient Neural Network (ENet) for segmentation of prostate gland with median lobe enlargement compared to manual segmentation. Materials and Methods: One-hundred-three patients with median lobe enlargement on prostate MRI were retrospectively included. Ellipsoid formula, manual segmentation and automatic segmentation were used for prostate volume estimation using T2 weighted MRI images. ENet was used for automatic segmentation; it is a deep learning network developed for fast inference and high accuracy in augmented reality and automotive scenarios. Student t-test was performed to compare prostate vol…

FOCAL LIVER LESIONS: CONTRAST-ENHANCED ULTRASOUND

Contrast-enhanced ultrasound (CEUS) represents a significant breakthrough in sonography and it is being increasingly used for evaluation of focal liver lesions (FLLs). The unique feature of CEUS of non-invasively assessing in real time liver perfusion throughout the vascular phase has led to a dramatic improvement in diagnostic accuracy of US in either detection and characterization of FLLs, as well as in the guidance and evaluation of response of therapeutic procedures. Currently, CEUS is included as a part of the suggested diagnostic work-up of FLLs, resulting in a better patient management and cost-effective therapy delivering. After a brief description of the basis of different CEUS tec…

Real-time spatial compound sonography of Achilles tendon in patients with heterozygous familial hypercholesterolaemia and normal physical examination

This study was undertaken to assess the prevalence and ultrasound features of Achilles tendon xanthomas (ATX) in patients with heterozygous familial hypercholesterolemia (HFH) and normal physical examination studied with high-resolution ultrasonography (HRUS) and, secondarily, to evaluate the role of real-time spatial compound sonography (CS) in terms of image quality.Both Achilles tendons of 40 patients with HFH were studied with HRUS and CS. Two experienced radiologists evaluated by consensus the presence of ATX described as (1) tendon thickening and/or (2) focal hypoechoic areas and the quality of images obtained with the two techniques.Ten out of 80 tendons showed thickening (mean: 11.2…

Influence of heart rate in the selection of the optimal reconstruction window in routine clinical multislice coronary angiography

Purpose. The aim of our study was to assess the influence of heart rate on the selection of the optimal reconstruction window with 40-slice multidetector-row computed tomography (40-MDCT) coronary angiography. Materials and methods. We studied 170 patients (114 men, age 60 +/- 11.3 years) with suspected or known coronary artery disease with 40-MDCT coronary angiography. Patients [mean heart rate (HR) 62.9 +/- 9.3 bpm, range 42-94 bpm] were clustered in two groups (group A: HR &lt;= 65 bpm; group B: HR &gt;65 bpm). Multiphase reconstruction data sets were obtained with a retrospective electrocardiogram (ECG)-gated 40-MDCT coronary angiography scan from 0% to 95% every 5% of the R-R interval.…

Arterially enhancing liver lesion: significance of sustained enhancement on delayed phase with MR imaging

HRCT and scleroderma: semiquantitative evaluation of lung damage and functional abnormalities.

This study sought to validate the Warrick score in the assessment of lung involvement in systemic sclerosis (SSc) and correlate the results with functional abnormalities. In addition, we propose the use of high resolution computed tomography (HRCT) indices of alveolitis and fibrosis to discriminate between different stages of the disease.Thirty-one patients with SSc (16 with the diffuse form and 15 with the limited form) underwent functional and HRCT evaluations of the lung. The semiquantitative evaluation of radiological involvement, as proposed by Warrick, provides a score for each lesion based on the severity and the extent of the pulmonary damage. In addition to the total score, indices…

MRI of the inner ear: use of modified GRASS and fast spin-echo sequences

We report our experience with MRI of the normal and pathological inner ear with fast spin-echo and modified gradient recalled at steady state sequences. Although earlier studies on temporal bone MRI were discouraging, improvements in MR technology combined with the use of paramagnetic contrast media can make MRI a useful diagnostic tool for the assessment of inner ear pathology. Conventional spin-echo imaging seems not to be the modality of choice because of the relatively thick slices and the long acquisition times.

T2-mapping of the sacroiliac joints at 1.5 Tesla: a feasibility and reproducibility study

Objective: To evaluate the reproducibility of T2 relaxation time measurements of the sacroiliac joints at 1.5 T. Materials and methods: Healthy volunteers underwent an oblique axial multislice multiecho spin-echo sequence of the sacroiliac joints at 1.5 T. Regions of interest were manually drawn using a dedicated software by two musculoskeletal radiologists to include the cartilaginous part of the sacroiliac joints. A senior radiologist performed the measurement twice, while a resident measured once. Intra- and inter-observer reproducibility was tested using the Bland-Altman method. Association between sex and T2 relaxation times was tested using the Mann-Whitney U test. Correlation between…

A xanthogranulomatous process resembling residual disease on endof- treatment 18f-FDG-PET/CT and Whole Body Magnetic Resonance performed on a primary breast lymphoma treated by ibrutinib plus rituximab-chop

We report the case of a woman, affected by breast diffuse large B-Cell lymphoma, who developed a xanthogranulomatous process wrongly interpreted as residual disease on 18F-FDG-PET/CTand Whole Body Magnetic Resonance after treatment with ibrutinib plus standard immunochemotherapy. Newer drugs, such as immunomodulatory agents and checkpoint inhibitors, have demonstrated high effectiveness on lymphoma, but are associated with unclear imaging features such as tumor flare or pseudo-progression, related to inflammatory reactions. Wide imaging techniques availability improves diagnostic possibilities. However, the awareness of the adopted treatment strategy and its possible implications on imaging…

Focal nodular hyperplasia: typical and atypical MRI findings with emphasis on the use of contrast media

Focal nodular hyperplasia is a benign hypervascular hepatic tumour, frequently detected in asymptomatic patients undergoing imaging studies for unrelated reasons. Magnetic resonance imaging (MRI) generally allows a confident differential diagnosis with other hypervascular liver lesions, either benign or malignant. In addition, due to the recent development of hepatospecific MRI contrast agents, MRI concomitantly enables functional and morphological information to be obtained, thus providing important clues for the detection and characterization of focal nodular hyperplasia lesions.

Contrast-enhanced US of liver hemangiomas atypical at baseline US

Pitfalls in whole body MRI with diffusion weighted imaging performed on patients with lymphoma: What radiologists should know

The technological advances in radiological imaging and the relevance of a diagnostic tool that may reduce radiation-induced long-term effects have led to a widespread use of whole body magnetic resonance imaging (WB-MRI) with diffusion weighted imaging for oncologic patients. A lot of studies demonstrated the feasibility and reliability of WB-MRI as an alternative technique for lymphoma staging and response assessment during and after treatment. In this paper, taking advantage of our 2years of experience using WB-MRI for lymphoma, we discuss the main pitfalls and artifacts radiologists should know examining a WB-MRI performed on this typology of patients in order to avoid images misinterpre…

0264: How to Address the Treatment of Idiopathic Plantar Fasciitis with Mini-Invasive Techniques: HRUS Criterion

FORENSIC INVESTIGATION IN AIR CRASH OF TUNINTER

Role of 64-slice CT multiplanar reconstructions in acute mechanical bowel obstruction

Whole-body magnetic resonance imaging (WB-MRI) in oncology: an Italian survey.

Purpose: To perform a survey among all members of the Italian Society of Medical and Interventional Radiology (SIRM) to assess how whole-body MRI (WB-MRI) is performed in oncologic patients in Italy. Methods: On March 2019, we administered an online poll to all SIRM members about their use of WB-MRI in 2018 asking 15 questions regarding oncologic indications, imaging protocol, use of contrast media, experience in WB-MRI, duration of scan time and reporting time. Results: Forty-eight members participated to the survey. WB-MRIs/total MRIs ratio was 1%. Lymphoma was the most common indication (17/48, 35%), followed by myeloma and prostate cancer, with these three tumors representing the most c…

Ruolo dell’ecografia transcranica con pulse inversion ed ecoamplificatore nel follow-up delle MAV cerebrali sottoposte a trattamento non chirurgico